
Class _JK_A_^i_5 

Book._ v^ G^ 

Copyright }1^ . 



COPYRIGHT DEPOSm 



ESSENTIALS 

OF 

PRACTICAL HYGIENE 

BY 

Frederick W. Smith, M. D. 

Obstetrician to St. Joseph's Hospital, Syracuse, N. Y.; 
Member of the Syracuse Academy of Medicine; 
the Onondaga County Medical Society; the 
Medical Society of the State of New 
York; the American Medical Associ- 
ation; and the American Public 
Health Association. ; >•* 

Formerly Commissioner of Health and Health 
Officer of the City of Syracuse, Secretary of the 
New York State Tuberculosis Committee, and 
Member of the New York State Board of Health . 



SYRACUSE, N. Y, 
1908 



^ 



k ^ i^ 






Two Oopies Hetcu-j:.- 

1 FEB IS 5 you 

5 OOpyiii^af civtrv 
COPY 6. 



Copyright, 1907. 

BY 

George K. Smith. 



The DuBois Press 

Printers and Publishers 

Newark, N. Y. 



DEDICATION. 



TO MY DEAR FRIEND 

DR. GREGORY DOYLE, 

OF SYRACUSE, N. Y. 
THIS VOLUME IS AFFECTIONATELY DEDICATED. 



When I began the practice of 
medicine in Syracuse in 1881, I 
was a stranger in a strange city, 
when I fortunately met Dr. Doyle, 
who extended to me the right hand 
of fellowship in such a manner 
that I feel that I owe to him and 
his lasting friendship and paternal 
advice, much of my professional 
success. 



PREFACE. 

This little volume does not as- 
sume to be a text-book or an elab- 
orate treatise on the subject of 
hygiene. It has, however, been my 
aim to present the subject in its 
most important phases in such an 
abbreviated and practical form as 
to be of interest and value to peo- 
ple who prefer simple facts rather 
than professional technicalities. 
The Authob. 



CONTENTS. 

Introduction 11-14 

Infancy and Childhood 15-24 

Adolescence 25-27 

Maturity 28-32 

Longevity 33-36 

Air 37-40 

Water 41-44 

Food 45-47 

The Value of Food 48-50 

Preparation of Food 51-53 

Diet 54-59 

Digestion and Assimilation 60-62 

Infant and Child Feeding 63-74 

Food Adulteration ........ 75-79 

Pure MHk 80-92 

Its Value as a Food. How to Pro- 
duce and Keep It 80-84 

Health of Employees 85-90 

Standard of Milk 90-92 

Personal Hygiene 93-99 



The Hygiene of Pregnancy 100-111 

Heredity 112-114 

Moral Hygiene 115-119 

Moral Hygiene of the Press .... 120-122 

Elements of Beauty ....... 123-127 

Social Hygiene ......... 128-132 

Patent Medicine and Drug Consumption 133-134 

The Use of Alcohol 135-139 

Intemperance ......... 140-144 

Household Hygiene 145-150 

Heating and Ventilation 151-155 

Infectious Diseases 156-178 

Tuberculosis 163-171 

Typhoid Fever 171-173 

Diphtheria 173-176 

Scarlet Fever 176-177 

Measles and Whooping Cough . . 177-178 

Disinfection 179-185 

by Sulphur 183-184 

'' by Formaldehyde .... 184-185 

School Hygiene 186-200 

Municipal Hygiene . 201-224 

Infectious Diseases 202-204 

The Laboratory ....... 204-205 

The Water Supply 205-206 

Pure Ice 206-207 

Dairy and Milk Inspection . . . 207-209 



. Disposal of City Waste .... 209 

Garbage 209-211 

Sewers 211-212 

Tenements and Public Buildings . 212-213 

Meat Inspection 213-214 

Poultry 214-216 

Abattoirs and Noxious Trades . . 216 

General Food Inspection .... 216-217 

Cold Storage Warehouse .... 217 

Inspection of Groceries and Shops . 218 

Medical Inspection of Schools . . 218-220 

Teach the Children 220-221 

Nuisances 221-222 

Smoke 222-223 

Street Dust 223 

Spitting 223-224 

Sanitary Education 224 

Political Hygiene 225-231 

Farm Hygiene 232-237 

Industrial Hygiene 238-239 

Economic Hygiene ........ 240-250 

Stream Pollution 240-241 

Sanitary Sewage Disposal . . . 241-246 

Soil Drainage 246-247 

Regulation of Streams 247-248 

Forestry 248-250 



INTEODUCTION. 

THE object of hygiene is to help people to live, 
keep well and enjoy life. Sound health 
should be the birthright of every human 
being. Good health is, however, often denied or 
made difficult or impossible by hereditary influ- 
ences, parental mistakes, or ignorance, family, 
social, endemic or community conditions, as well 
as by personal violations of the laws of nature, 
intemperance, vice, or excesses of various forms, 
all of which influences are within the province of 
hygiene to prevent. 

A knowledge of the principles of hygiene is of 
much assistance in the conduct of life under nor- 
mal conditions. It is of the greatest importance 
to those who find themselves physically deficient, 
or obliged to live under unfavorable conditions or 
surroundings. 

Its principles are applicable to every period or 
condition of life, and to every industry, calling or 
pursuit. Practical hygiene might well be termed 
the science of life. By the observance of its prin- 
ciples many of the dangerous paths of life are 
safely crossed, health and enjoyment of life main- 



12 Practical Hygiene 

tained, many lives saved and many lives pro- 
longed. 

The first essential of enjoyment at any period 
of life is good health. It is the one thing most 
needed and desired by all humanity, and it is at 
the same time a fact that bnt a small proportion 
of people enjoy perfect and continuous good 
health, notwithstanding that nearly all diseases 
or disabilities are preventable. 

To make the most of life, we must be strong 
mentally and physically; we must know what to 
eat, how to work, exercise or rest and care for the 
body; we must know ourselves and our unfavor- 
able tendencies, idiosyncrasies and environment, 
which a knowledge of hygiene will enable us to 
correct. 

" 'Tis the sublime of man, 

Our noontide majesty, to know ourselves 
Parts and Proportions of a wondrous whole." 

—Coleridge. 

It should be the first duty of legislative bodies, 
and of all others having authority, to bend every 
eifort to accomplish the most perfect protection 
to life and health. 

Sanitary legislation and laws are futile unless 
supported by public opinion, without which sani- 
tary executive officers can accomplish but little. 

Public opinion is but the exponent of the intelli- 
gence of communities. 



Practical Hygiene 13 

The attitude of courts and executive officers 
may be influenced by the standard of intelligence 
or righteousness of communities to which they 
owe their existence. 

The masses of the people must, therefore, have 
a better knowledge, not necessarily of disease and 
bacteriology, which they do not understand, but 
of the practical advantages of health, cleanliness 
and favorable environment, which they can com- 
prehend, and to which they can attach a social and 
commercial value. 

The triumphs of hygiene and the sanitarian 
form the brightest pages in the history of the past 
century. By their efforts, the average age has 
advanced nearly fifteen years in the last two gen- 
erations, thereby increasing largely the pleasures 
and possibilities of life, and promoting propor- 
tionately, ** national, state, municipal, community 
and individual prosperity, industry and achieve- 
ment. ' ^ 

While there have been great advances in the 
practical application of hygiene in recent times, 
we can see in the future still greater possibilities, 
by its influence on posterity in the prevention of 
disease, degeneracy, crime and unfavorable hered- 
ity, and thus in the further prolongation of hu- 
man life. 

Elements preventing sanitary progress are pre- 
judices, indifference, ignorance and selfishness. 



14 P r actic al H y giene 

The importance of many public health problems 
are of the first magnitude, and their solution de- 
pends on conditions, educational, social and 
political. 

It is obvious that in education rather than in 
legislation lie the most potent factors for advanc- 
ing the cause of hygiene and sanitation. Yet, in 
the presence and possession of requisite knowl- 
edge, intelligent people will violate the laws of 
nature, and sacrifice their self-respect, their 
health, and even life itself, for the acquisition of 
wealth and the satisfaction of petty ambitions or 
pleasures. Hence the necessity for sanitary law, 
and the general need of higher ideals of character 
and morality. 

If health were only contagious, vice difficult, 
and virtue steadfast, health and righteousness 
would be common. Would it were so ! 



INFANCY AND CHILDHOOD 

A HEALTHY man and woman should beget 
healthy children who will reach their inde- 
pendence in the full enjoyment of normal 
conditions of mind and body, if they have been 
permitted proper opportunities for development. 
Their complete growth and best attainments can 
only be obtained under conditions insuring a con- 
tinuous perfect health. 

The long duration of the period of infancy and 
helplessness in the human race constitutes a fea- 
ture signally distinguishing it from other mam- 
mals. 

It is said that at least one-third of all children 
born die within the first five years of age. 

Statistics from various localities in town and 
country concur in showing the highest mortality 
of life to be during the first twelve months, the 
rate varying from one-fifth to one-third. Factors 
entering into the causation of this large and pre- 
mature mortality are : Unfavorable heredity, will- 
ful prevention of conception or attempts at foetal 
destruction, parental ignorance, or errors in feed- 
ing and general management. 



16 Practical Hygiene 

The largest proportion of deaths in infants 
occur during the summer months. 

While hot weather doubtless exercises a de- 
pressing effect, and thus influences their health 
and vitality, mortality in infants is affected more 
by the effect of hot weather on their food, espe- 
cially among the poor. Death among infants dur- 
ing the first or second year of life is largely due 
either to improper food, or inability to assimilate 
food, or to what is known as digestive disorders. 

The first year, even the first six months, is the 
most important time of the entire period of de- 
velopment. This is the time for laying the foun- 
dation for future health and perfect development. 
A period of disease or defective nutrition in the 
child's first year of life may seriously curtail its 
growth and usefulness in after life. We some- 
times wonder how so many infants survive in the 
presence of the ignorance and incompetence of 
many nurses and mothers. 

In these days of progress there are many 
** scientific '' babies deserving the sympathy of 
intelligent people ; babies that are raised by rule ; 
that must be fed at certain times, whether they 
are hungry or not, and with exactly measured 
quantities, regardless of the fact that what will 
satisfy one will be quite insufficient for another, 
and if not satisfied they can't be hungry, for the 
chart says the amount is sufficient for infants of 



Practical Hygiene 17 

that age. These *^ by rule '^ babies must always 
sleep certain hours, and wake at stated times, and 
if they do not like it they can lie in bed and cry till 
they are ill, for rules must not be broken. 

Eules are good things, even for babies, but they 
must sometimes be laid aside and the faculty of 
judgment substituted. Children, like adults, have 
different temperaments, varied digestive powers 
and capabilities for sleep, all of which must re- 
ceive due consideration. Babies are, however, 
very much alike and, in general, need similar 
treatment. 

The infant should be left very much alone dur- 
ing the first month, and should not be handled 
more than is necessary for nursing, bathing and 
change of clothing. At this time it is an animal 
without reason, and needs no entertainment or 
diversion, but will, however, express by its action, 
its appreciation of comfort or discomfort. 

Care should be exercised not to permit the child 
to sleep always in the same position. Its bones 
are soft and pliable, and deformities of face or 
body have been thus produced. For the first 
month its eyes should be protected from bright 
sun or artificial light. 

The infant is sensitive to draughts and cold 
and should be kept warm, but in a pure atmo- 
sphere. 

For convenience of mother or nurse a movable 



18 Practical Hygiene 

bed should be provided for the child, so that it can 
be moved from one room to another without wak- 
ing it. A basket of suitable size answers an ex- 
cellent purpose, but it should be without rockers 
or swinging motion. 

After nursing, the child should be placed in its 
own bed and never allowed to sleep with its 
mother, as it soon learns to like the warmth of its 
mother's body and will afterward refuse to sleep 
when placed in its own bed. 

All children should be bathed daily from birth. 
The bath should be given at a regular time in the 
morning, just before the second feeding; after 
feeding the child will usually go to sleep and sleep 
for two or three hours. The bath for the first 
month should be given at the temperature of 100 
degrees, Fahrenheit, and should be given without 
exposure to draughts. By the sixth month the 
bath may be given at the temperature of 95 de- 
grees, Fahrenheit, and at the end of the first year 
it may be lowered to 90 degrees. After the bath 
give the child a gentle rubbing with the bare hand, 
giving special attention to the back, arms and legs. 

During childhood the warm bath is best given at 
bed-time, and a cool sponge bath, at 70 degrees, 
Fahrenheit, should be given in the morning ; this 
should not be of more than a minute's duration. 
It should be given in a warm room and followed 
by a brisk rubbing of the entire body. 



Practical Hygiene 19 

The mouth of the infant should be gently 
cleansed each morning with sterile water and a 
piece of soft gauze. The primary, as well as the 
permanent teeth, should receive daily attention. 
The teeth in young children should be cleaned with 
gauze instead of a brush. 

Before giving the bath, the infant's abdomen 
should be gently massaged, and during the proc- 
ess, the anus occasionally touched with the finger 
tip. Usually in this manner the bowels will be 
caused to act. If not successful at first, repeat the 
operation daily, and finally an excellent habit will 
be established ; a habit important to the health and 
comfort of the child, and economizing the time and 
labor of nurse or mother, and one of much assist- 
ance in teaching the use of the chair. When regu- 
lar habits for movement of the bowels have been 
established and the child is old and strong enough 
to sit up, it can easily be taught the use of the 
chair if placed upon it just before the expected 
movement. Children easily and early form habits, 
good or bad, and the nurse who fails to leave the 
child at the end of a month with established habits 
for feeding, sleeping and bathing, fails in doing 
her duty. If the habit of regularity in baby's 
daily routine is started early in infancy, it is easily 
continued through childhood, will follow as a mat- 
ter of course in after life and always be advanta- 
geous to health. 



20 Practical Hygiene 

Infants should always be clothed in soft flan- 
nels. An abdominal band of plain flannel should 
be worn for the first six months. 

In summer the outer clothing should be light 
and the underclothing of thinnest flannel. Infants 
are as susceptible to changes of temperatures as 
adults, and judgment must be exercised in their 
clothing. The custom of allowing young children 
of any age to go with bare arms and legs is dan- 
gerous except in warmest summer days. 

Cotton diapers absorb moisture better than 
linen, and are, therefore, to be preferred. 

The drying of soiled diapers or other clothes in 
the nursery, or anywhere in the house, should not 
be tolerated. It pollutes the atmosphere and 
smacks of laziness and lack of cleanliness. No 
matter how slight the soiling, they should be 
washed and dried before using. The using of 
soiled diapers, dried without washing, causes sore- 
ness of the child's buttocks and is offensive to the 
sense of smell and common decency. Diapers 
should always be changed as soon as wet. After 
each change the buttocks should be washed, care- 
fully dried and powdered. 

One of the first things baby must learn is that 
he is not to be taken up and amused or carried 
about every time he is awake and not nursing. It 
is a great mistake to take up a child and attempt 
to stop its every cry by attracting its attention. 



Practical Hygiene 21 

nursing it, or stuffing some object into its mouth. 
Pernicious habits and ill-temper are soon devel- 
oped and are with difficulty corrected. The prac- 
tice of many mothers and nurses of keeping a 
nipple or ^' comforter " of some sort in the baby's 
mouth during its waking hours is harmful. It is 
liable to result in various infections and digestive 
disturbances. 

After the morning bath the child should be per- 
mitted to sleep two or three hours, if it will. After 
that it should be fed at regular intervals during 
the day, regardless of sleep ; and if asleep at the 
time for feeding it should be wakened and fed, for 
if it gets too much sleep during the day it will not 
sleep well at night, and if it does not get its regu- 
lar and required amount of nourishment during 
the day it will likely want it during the night, and 
will thus turn night into day. 

Until the child is four months old it should be 
nursed once between 10 p. m. and 7 a. m. After 
the fourth month all feeding between these hours 
should be discontinued. 

Eegular sleep and feeding materially simplify 
the infant 's care and are also of much importance 
to its health. 

After the child is a week old it should be well 
wrapped, its face covered with a heavy veil, and 
taken out of doors daily, at first only for a 
few minutes, but the time may be gradually 



22 Practical Hygiene 

lengthened to the full period between feedings. 

When the infant is a month old it is well to be- 
gin to play with it a little. Exercise is as impor- 
tant at this time as later in life. 

The almost incessant movements of infants go 
to show the imperative necessity of physical exer- 
cise and should teach the importance of extending 
to the child every opportunity for the taking of 
such exercise as it instinctively seems to require 
as its development progresses. Freedom of mus- 
cular action should not be restricted by dress. 

The crying of young infants doubtless serves a 
useful purpose in the exercise of certain muscles 
and aids in the development of the chest. All chil- 
dren are more or less noisy. Their healthy cries 
are necessary for their development and should be 
encouraged rather than repressed. 

Every opportunity should be given to stimulate 
activity. As soon as they are able to grasp ob- 
jects they should have such playthings as they can 
handle without harm to themselves. 

As soon as he can roll or creep about the baby 
should be encouraged in his efforts by placing him 
upon a thick comfortable on the floor, where he 
can tumble about at will. 

Teething normally begins about the sixth 
month. Teething is not, in itself, a cause of dis- 
ease, and if children are well, and have good hab- 
its of digestion and sleep, no trouble will be ex- 



Practical Hygiene 23 

perienced ; but if previous ill health or weakness 
exist, the irritation of teething, which, in normal 
or healthy children would cause no trouble, will in 
the weakling be the exciting cause of reflex 
troubles. 

If the first six months of life have been an unin- 
terrupted period of health and growth no trouble 
need be expected in the second. 

There seems to be a prevalent idea that the 
second summer is the most critical period of in- 
fancy, but this is not true. More children die in 
the first year of life than in the second. If a child 
has been well in its first year it will, if it has 
proper care and food, be likely to continue well in 
its second year. If trouble comes in the second 
year it is more likely to be due to errors in diet 
than to anything else. 

Children, male or female, should always be 
made to sleep alone. By sleeping together chil- 
dren have innocently developed habits resulting 
in serious functional and nervous disorders. 

Degenerates, dependents and even criminals 
may result from deficient or improper home 
training. The physical health of children often 
depends much on proper mental and moral train- 
ing. 

Keep the children happy, but do not be over in- 
dulgent. Do not govern by petting or by unneces- 
sary severity. Avoid anything tending to develop 



24 Practical Hygiene 

in them fear or cowardice. Give children as much 
liberty as possible; liberty develops courage and 
self-reliance. 

They must learn some things by experience. If 
they persist in ^* playing with the fire " they 
should be permitted to be slightly burned. 

Wilfulness and disobedience must be overcome 
in the second year of life and are often much in- 
fluenced by the child's training in its first year. 
Parents must remember that irritability and 
nervousness are often the result of functional dis- 
orders needing medical treatment. 

Childish obstinacy and youthful activity must 
be carefully and moderately restrained, as they 
breed persistency and energy, both desirable 
qualities of adult life. Lawless and disobedient 
children are almost invariably the result of par- 
ental mistakes. 

The good government of children requires in- 
telligent co-operation on the part of the parents ; 
their study of the individual peculiarities of chil- 
dren, due cognizance of their possible ancestral 
elements of character, and the ability to exercise 
good judgment, forbearance and perseverance. 



ADOLESCENCE. 



ADOLESCENCE is that period of life be- 
tween the beginning of puberty and full 
mental and physical development and is a 
most important time in every life. 

In males the period comprises the average time 
between the ages of 14 and 25, and in females be- 
tween the ages of 12 and 21. 

During this period the mind is most impression- 
able and susceptible to influences which unalter- 
ably mould and ^x the character and destiny of 
the individual. 

It is here that parents should most fully appre- 
ciate their responsibility for the future of their 
children, the necessity for the application of a 
correct precept and example, and the exercise con- 
tinuously of their best judgment and fullest 
knowledge for the development of character and 
in the correction of unfavorable moral and physi- 
cal tendencies, either hereditary or acquired. 

Good associations, correct instruction and 
proper habits of life and modes of living, devel- 
oped at this time of life, are most essential to 
future happiness and usefulness. 



26 Practical Hygiene 

When the children arrive at the age of puberty 
parents have an imperative duty to perform in 
instructing them as to the nature of certain func- 
tions that become established at that time, the 
sacredness of marriage and parentage, the physi- 
ology of reproduction and the dangers attending 
the improper or illicit exercise of the sexual func- 
tions, and the advantage, the beauty and assur- 
ance of physical, social and moral purity. 

Silence and ignorance are the parents of indif- 
ference and vice. Give the children a chance for 
their honor, their self-respect and for their lives. 
Fathers, do not let your sons learn from others 
or from bitter experience (possibly incapacitating 
them for life) what you should have told them. 
Mothers, do not by your indifference, or false 
modesty, ruin the reputation of your daughters or 
send them to suicide and death. 

A large proportion of the mistakes and vices 
occurring in the lives of young men and women 
are the result of ignorance or indifference, due to 
nothing more than criminal neglect on the part of 
parents, in their failure to caution their children 
against temptation and to teach them some things 
that it is absolutely essential they should know 
about themselves. 

If parents are foolish enough to think they are 
unable or incompetent to give this instruction they 
should delegate the duty to the family physician. 



Practical Hygiene 27 

The duty properly belongs to parents, for because 
of their greater interest it comes from them with 
greater force and best results. This instruction 
might properly become a part of the education of 
young men and women in the higher schools and 
colleges. 

Young men should know that chastity is entirely 
compatible with perfect health. They should also 
know that a certain function appearing at the age 
of puberty is a normal physiological process, not- 
withstanding the literature which is so liberally 
distributed by the medical charlatans and which 
also appears so abundantly in many periodicals 
and daily papers. That such literature is solely 
for the purpose of preying on the minds and pock- 
ets of young men who do not understand them- 
selves is well known. The literature referred to 
is familiar to all and should be suppressed by 
statute. It has, I am sure, sent many a young 
man, not in the possession of the requisite knowl- 
edge of his sexual functions, either to the insane 
asylum or to an early grave, because of the mental 
suffering it has needlessly and wrongfully excited. 



MATUEITY. 

MATUEITY is the period of life when full 
development of mind and body is sup- 
posed to have been attained. 

The exact age varies. In men it may be said to 
be at an average age of 24 or 25 years, and in 
women, 21 or 22 years. 

At this age, if not before, intelligent individuals 
should be able to recognize their physical peculiar- 
ities, defects or shortcomings, and to safeguard 
their future. 

Physical defects of children should have been 
recognized by parents in childhood or adolescence, 
and remedied before the age of maturity; but 
even then much may be done for correction or im- 
provement of physical defects, by proper exercise, 
mode of living, or by attention to details of per- 
sonal and general hygiene. 

At maturity, and often before, individuals be- 
gin to assume the responsibilities of life. At this 
time they should realize that future success, use- 
fulness and happiness depend more on continuous 
good health than on business sagacity or secrets 
of trade, and that the acquisition of wealth is not 



Practical Hygiene 29 

the true goal of human success ; that a sound body 
imbued with a sound character insures the success 
that brings the contentment of a healthy con- 
science, and wins the approbation of fellow men. 

Wealth is of little account to a man of fifty if he 
begins to die at forty. 

In assuming the duties and responsibilities of 
life, all should have foremost in their minds the 
preservation of health and proceed to adopt such 
modes of life as will best promote health, strength 
and longevity, having in mind that, if the age of 
forty years is reached in the full possession of an 
unimpaired general vitality, the most useful 
period of life is yet to come, and that there is then 
a favorable prospect of reaching a good old age. 

Many men have done their best work at three- 
score or more and some have done great work at 
eighty years of age. But few of the world's great 
men have reached their period of best judgment 
or fullest capabilities until after forty. 

At this age multitudes of men and women have 
reached a condition of pre-senility induced by the 
too strenuous struggle for wealth, or for the grati- 
fication of ambition; by intemperance in eating 
or drinking, by indolence or other pernicious 
practices or habits of life. There seems to be a 
progressive tendency in modern methods of busi- 
ness, recreation and the demands of social func- 



30 Practical Hygiene 

tions, to overwork and overplay and to take too 
little relaxation. 

The rapid, ^ ' high-rolling ' ' life of many young 
men and women of the present time is productive 
of evil results to their physical and moral welfare. 
Among many young people there is too much 
worship of the ' ^ good time, ' ^ and too little rever- 
ence for virtue, truth and nobility of purpose. 
There is too little thought for the future and 
higher aims of life. 

Young men when obliged to leave the parental 
home should strive to place themselves among 
the influences of family life. The influences em- 
anating from ** bachelor quarters ^' are not con- 
ducive to the development of the instinct for fam- 
ily and home life, and have carried many a young- 
man past the time when he is best fitted to himself 
become the head of a family. 

All healthy men should marry before they are 
thirty or as soon before as they can comfortably 
support a wife; and healthy women, the earlier 
the better after the age of maturity. Early mar- 
riages give an average of best results, from every 
standpoint. 

There is nothing in life superior to the charm 
of the family home. The poor man or woman with 
a family can take comfort in the thought that they 
are giving to the world a better generation of men 
and women. If they are educating children they 



Practical Hygiene 31 

are doing a great work and can well afford to be 
patient, self-denying and hard worked. 

*' To make a happy fireside chime 
To weans and wife, 
That's the true pathos and sublime 

Of human life." —Burns. 

Eeasons for the too frequent failure of mar- 
riage are to be found in both parties to the con- 
tract. 

Young women are too willing to marry with- 
out thought or preparation for their future. 
Woman 's best work is in the home and for its im- 
portant duties she must fit herself by intelligent 
study and thorough preparation before marriage, 
having in mind that the objects thus attained are 
of vital importance to her own future health and 
comfort, and involve also the welfare of the fam- 
ily, perhaps its very existence. 

They must have a thorough understanding of 
household duties, and know how to promote the 
health and comfort of the family. They must 
also have knowledge of the requisites of mother- 
hood, and the essentials for maintaining the 
growth and development of the child; and, if 
necessary, be able to take charge of it, and recog- 
nize in it opportunities for self-sacrifice, devotion 
and the cultivation of their highest ideals. 

A keen intellect and well-directed energy are 



32 Practical Hygiene 

valuable acquisitions, which a woman is likely to 
impart to her husband and children. Men are 
often what women make them. 



LONGEVITY. 



4 4'Tr'HAT life is worth the living and that 
I long life is a prize the majority of man- 
kind will declare affirmatively.'^ 

Owing to the progress of medicine, hygiene and 
general sanitation, the span of life is constantly 
increasing and it is reasonable ta believe that a 
further evolution of our intelligence and right- 
eousness will enable us, in many ways, to conserve 
or increase our vitality and maintain a nervous 
equilibrium, a more favorable environment, and 
thus still further prolong the average duration of 
life, its period of usefulness and enjoyment. 

The most favorable conditions promoting long- 
evity are not found in either of the extremes of 
the conditions of life. It is unnecessary to men- 
tion the deterrent influences of poverty. In the 
higher walks of life, the favorable environment, 
the comforts, luxuries and privileges of wealth 
are often more than overbalanced by cares, anxie- 
ties, social obligations, indulgences, or indolent 
habits inconsistent with health. 

To live long one must have sound organs, good 
digestion, an ability to sleep well, regular habits, 



34 Practical Hygiene 

occupation, a cheerful disposition, and be temper- 
ate in all things, avoid all stimulants, including 
tea and coffee, sleep in well ventilated rooms and 
take frequent baths. 

Health is not promoted by early rising without 
a corresponding * * early to bed. * ' 

It is a mistake for a well man to stop work at 
any time of life, for, without occupation, degener- 
ation of mind and body soon begins ; there must 
be neither idleness nor overwork. 

Eetention of the faculties for work or pleasure 
requires constant cultivation and exercise in mod- 
eration. The nervous strain of false position, liv- 
ing beyond one's means, the high speed, high 
pressure habit, all tend to shorten life. Modern 
industrialism and commercialism are demoraliz- 
ing physically and morally. The sweat shop has 
its victims, the counterpart of which is found in 
the victims of ^* high finance.'' 

Don't become speed crazy either in business or 
pleasure. 

A more perfect intelligence in the matter of 
eating and drinking and a practical application 
of the principles of hygiene, should enable all 
healthy adults to reach the age of four-score or 
more of years in the full enjoyment of all their 
faculties. 

Eeasonable energy and ambition are desirable 
and laudable qualities, necessary for success. 



Practical Hygiene 35 

Hurry if necessity requires it, but don't get the 
habit of rushing frantically all the time without 
cause. Take time to eat properly. Don^t over- 
eat. Don^t eat and run immediately. '' Don't 
burn the candle at both ends. ' ' 

Sleep eight hours, if possible. If you have a 
bicycle for health and amusement, don't try to 
break the road record and thereby add injury, in- 
stead of needed recreation and benefit to your 
tired nerves and muscles. 

If you own an automobile, this most delightful 
and healthful means of recreation may be made 
most nerve-wrecking and muscle-tiring by driv- 
ing like a lunatic from place to place, with no par- 
ticular object except to beat some previous record. 

Constant hurry and rush result in early decay 
of vitality and in shortening the period of useful- 
ness and ability to enjoy life. 

Keep the bowels active, avoid big dinners, ex- 
citement, anxiety, or envy; eat slowly. 

If you would live long and be happy, be delib- 
erate, placid and cheerful, live moderately, don't 
worry, don't rush. Take the advice of Abraham 
Lincoln : ' ^ Do not worry ; eat three square meals 
a day ; say your prayers ; think of your wife ; be 
courteous to your creditors ; keep your digestion 
good; steer clear of biliousness; exercise; go 
slow and easy. Maybe there are other things 



36 Practical Hygiene 

your especial case requires to make you happy, 
but, my friend, these, I reckon, will give you a 
good life.'' 



AIR. 

OF all the needs of man the most indispen- 
sable is air, for it contains the most im- 
portant of all elements to the human 
economy, oxygen, without which life soon goes out. 
Normal or pure air is a mixture of gases repre- 
sented by 20.96 volumes of oxygen, 79 of nitrogen 
and .04 of carbonic acid, with watery vapor in 
varying amount. Any considerable variation in 
its component parts renders it impure and detri- 
mental to health. 

The principal source of atmospheric impurities 
is the respiration of man and the lower animals. 
The purity of air is unfavorably influenced by 
soil pollution and excessive soil moisture, imper- 
fect drains or sewers, by noxious trades and in- 
dustries, and by the neglect or improper care of 
organic wastes, and by combustion, fermentation 
and putrefaction. In the process of respiration, 
oxygen is reduced and carbonic acid increased. 
Watery vapor and a small amount of organic 
matter are also given off by the lungs. A small 
amount of carbonic acid and moisture are also 
given off through the skin. Carbonic acid is a 



38 P r actical E y g iene 

waste product of the body, and a poisonous excre- 
tion. In crowded assembly rooms it will be found 
in largely increased proportion, unless removed 
by ventilation. It occurs liberally as the result of 
the combustion of coal, oil, gas, or other elements, 
and the burning of gas, lamps, or open fires in 
closed rooms soon renders the air unfit for sus- 
taining life. 

Aside from liberating a poisonous gas, com- 
bustion rapidly vitiates air by removing oxygen. 

The burning of a cubic foot of gas consumes the 
oxygen from six cubic feet of air, and produces 
two cubic feet of carbonic acid. 

An important and dangerous element often 
present in the air of houses or other buildings is 
carbon monoxide, resulting from the leaking of 
gas pipes, the imperfect combustion of gas, or to 
defective furnaces. 

Air vitiated by putrefaction is twofold — chem- 
ical, by the liberation of carbonic acid and other 
noxious gases, and organic, by living organisms, 
which are distributed chiefly as dust. Dust plays 
no small part in air pollution in households, and 
in city or country, dust carries various bacteria 
and disease-producing organisms. It is irritating 
to mucous membranes, and if it does not excite 
disease, it predisposes to influenzas and catarrhal 
diseases. 

Pure air is essential to good health. It is a 



Practical Hygiene 39 

matter of common observation that in proportion 
as people are obliged to live or work indoors, dis- 
ease and death rates increase, and that vitality 
and activity are diminished by overcrowding and 
other conditions causing air pollution or vitiation. 

The feeling of fatigue resulting from a day's 
ride on a railroad train is often greater than that 
produced by a full day's tramp, and it is doubt- 
less due to breathing air vitiated by the process 
of respiration, and indirectly to deficient ventila- 
tion. Ventilation of cars, rooms, habitations or 
places for work is necessary to remove the poi- 
sonous products of respiration as well as for the 
maintenance of a supply of oxygen which is being 
constantly consumed. 

The immediate effects of breathing vitiated air 
are a feeling of lassitude, headache, dizziness or 
faintness, and if long continued, a gradual failing 
of health is shown by loss of appetite, pallor and 
anaemia, and thus is created a predisposition or 
favorable condition for the development of any 
disease, especially tuberculosis. The purity of 
air is favorably influenced by trees or forests and 
general vegetation, which, in the process of 
growth, consumes atmospheric impurities and at 
the same time liberates the important element, 
oxygen. 

Air pollution or vitiation must be prevented by 
regulating noxious trades, the proper disposition 



40 P r actical H y giene 

of waste products, by preventing smoke and dust, 
and by the installation of scientific devices for 
lighting, heating and ventilation of cars, habita^ 
tions, industrial buildings and places of public 
gathering. 



WATER. 

AFTER air, water is the next most essential 
element necessary for human existence. 
Without water, human life lasts but four 
or five days. The human body consists of about 
seventy per cent, of water, by weight, and requires 
for its support from three to five pints daily. 

Disease, and even death, from drinking impure 
water, have become very common. 

Typhoid fever is the principal water borne dis- 
ease. If the fecal discharges of a typhoid case 
are thrown into a privy vault, discharged into a 
sewer, or buried in the ground, without proper 
disinfection, the typhoid bacillus is liable to find 
its way to some potable water, and spread the 
disease. 

The necessity for pure water requires no 
argument. 

Water for potable purposes is taken from lakes, 
rivers and small streams, springs and wells. Rain 
water is also largely used for potable purposes. 

Water from all sources is capable of contamina- 
tion, and is often rendered dangerous by poison- 
ous, organic or mineral elements. All bodies of 



42 Practical Hygiene 

water, running streams, springs and wells may be 
contaminated by sewage, and by the drainage of 
surface water containing organic matter of vari- 
ous kinds. In rural districts and on the farm, 
well water is often contaminated by drainage from 
the privy vault, cesspool or stable. Eain water is 
contaminated by dust and organic matter floating 
in the atmosphere, or deposited upon roofs or gut- 
ters or buildings from which it is collected. Water 
stored in lead lined tanks will absorb enough lead 
to make it dangerous for drinking purposes. 

Filter beds for purifying municipal water sup- 
plies will remove silt, gross impurities, and much 
organic matter, and largely the dangerous bac- 
teria, but cannot render badly contaminated 
water absolutely safe. Household filters will do 
as much, but no more, when they are new and 
clean, but they are nasty things at best, and when 
it is necessary to use them they must be fre- 
quently cleaned and renewed, and water that must 
be filtered through them should afterward be 
boiled. In the absence of positive assurance as to 
the purity of drinking water, it should always be 
sterilized by boiling. 

If possible, avoid drinking from pools, springs 
or streams where rocks or stones are covered with 
a green slime ; for, while the water may be pure, 
such conditions indicate the presence of organic 
matter. The water from springs or streams hav- 



Practical Hygiene 43 

ing in them clean stones, or bright, shining sand 
is probably safe. 

The water supply of farms, rural districts and 
villages, while it should be better, is often more 
likely to be doubtful or dangerous than the water 
supply of large towns or cities, because of the fact 
that they are not as well protected, or as fre- 
quently examined to determine their true condi- 
tion. 

Contamination of well water sometimes occurs 
from unexpected sources. The typhoid bacillus 
deposited in the privy vault may find its way 
through porous soil to the well located far away. 

Unfortunately, good appearance and taste offer 
no guarantee of the purity and safety of water. 

An ideal water must be above suspicion. 

To maintain any water supply above suspicion 
requires a frequent chemical and bacteriological 
examination; but if there is possibility of drain- 
age from privy vaults, stables, cesspools or sew- 
ers, it does not require either a chemist or bac- 
teriologist to prove that there is danger. Our 
common sense should tell us so. 

The chemist may find chlorine, albumenoid am- 
monia, or nitrites, indicating pollution from sew- 
age or other organic matter, but it requires the 
bacteriologist to find the bacteria which indicate 
more clearly the source and dangerous character 
of the contamination. 



44 Practical Hygiene 

The city maintaining a water supply is morally 
and legally bound to furnish safe water. It must 
not be satisfied with a report from the laboratory 
that the water is pure until it has a constant police 
surveillance of the water shed, not only correcting 
unfavorable conditions, but preventing all pos- 
sible and even improbable causes of contamina- 
tion. 



FOOD. 

BY food we include everything taken into the 
stomach to support life, nourish or repair 
structure, and supply force and energy. 

The human body is made up principally of such 
chemical elements as nitrogen, hydrogen, carbon 
and oxygen, and in smaller proportions, of cal- 
cium, sodium, iron, sulphur and other salts, all of 
which must be added to daily, for purposes of 
growth, sustenance, reproduction or repair of 
waste, and thus maintain a normal condition of 
health. 

Foods are classified as organic and inorganic. 
Organic foods are Nitrogenous and Non-Nitro- 
genous. 

Nitrogenous foods are those containing proteids 
or albuminoids and represented principally by 
meat, fish, eggs, milk, cheese, peas, beans and 
cereals. 

Non-nitrogenous foods are the carbohydrates, 
or those containing sugar, starch and fats. 

The inorganic food elements are the various 
mineral substances, oxygen and water. 



46 Practical Hygiene 

The principal tissue-forming elements are the 
proteids, mineral matters and water. 

The heat-producing elements are the carbohy- 
drates or the starches, sugar and fats. Starchy 
foods comprise a large proportion of the ordinary 
diet. In the process of digestion they are con- 
verted to sugar. Starch exists abundantly in 
potatoes, nuts and all cereals. Sugar forms an 
important food. Its chief source is the ordinary 
cane or beet sugar. It exists in varying propor- 
tions in all fruits and constitutes their chief nutri- 
tive element. 

An element most essential to the proper devel- 
opment and nutrition of the human body is oxy- 
gen, although not strictly a food. Two thousand 
cubic feet of pure air must pass through the lungs 
of an adult daily in order to supply oxygen in suffi- 
cient quantity to permit of chemical changes 
necessary for assimilation, nutrition, and excre- 
tion of waste and poisonous products. 

Water comprises nearly two-thirds of the hu- 
man body by weight. A large amount is given off 
from the body daily, and a like amount must be 
supplied. 

Mineral matter is essential to maintain both 
form and stability of the body and necessary 
chemical action for digestion, assimilation and 
nutrition. With the exception of common salt, 



Practical Hygiene 47 

mineral matter exists in nearly all foods sufficient 
for bodily needs. 

Fat forms about one-fifth the normal body 
weight. The fat-producing elements of food are 
derived from fatty or starchy food and sugar. 
The oxidation of fat produces necessary heat, and 
thus prevents, in a measure, waste of living tis- 
sue. Fatty foods and fat-producing foods are 
therefore necessary for these purposes as well as 
to contribute to the formation of tissue. 

Protein or nitrogenous food is necessary to the 
development of muscle or the nitrogenous tissues 
of the body, to repair waste of such tissues, and 
to furnish muscular and nervous energy. Protein 
is of both animal and vegetable origin ; its chief 
sources are lean meat, fish, eggs, milk and cheese. 
It exists in large proportions in peas, beans, and 
in lesser degree in all cereals. 



THE VALUE OF FOOD. 

FOOD is as necessary to the human body as is 
fuel to the locomotive. Good fuel, proper 
stoking and an intelligent care of the plant 
is necessary if the best work and energy is to be 
expected of boilers and engines. The digestive 
system is the firebox of the human economy, and 
for best results it must be supplied with good food 
selected with an intelligent knowledge of the re- 
quirements, as to form and quantity, of the vari- 
ous demands or periods of life. 

A knowledge of the nutritive value of various 
foods is especially important to those who find it 
essential that money spent for food should bring 
the largest possible return. 

Those foods which are derived from the vege- 
table kingdom are the cheapest. 

Food is the source not only of sustenance and 
growth, but of capacity for work. Thus a man's 
capacity for work depends much on the quality 
and quantity of food he eats. 

Bread is the cheapest single food furnishing the 
nearest approximate to the required amount of 
protein and energy for a laboring man. Oatmeal, 



Practical Hygiene 49 

peas, beans and potatoes come next in order. As 
an adjunct food and producer of energy, sugar is 
an important and cheap food. Cheese is strong in 
proteid and energy, and is a cheap source of both. 
Milk, while a wholesome and nourishing food, and 
absolutely necessary for the nutrition of young 
children, is a comparatively expensive food for 
adults. Beef is the most expensive of meats and 
as a producer of proteid and energy is several 
times more expensive than bread. Fowl is more 
expensive than beef. Ham, bacon, sausage, fresh 
pork and mutton are richer in proteid and energy, 
and thus cheaper than beef. 

Fish, while less nutritive than meat, is a cheap 
food. 

Eggs are rich in proteid and energy and at ordi- 
nary prices are less expensive than meat. 

Butter, olive oil and other fats are strong in 
producing heat and energy, and therefore cheap 
foods. 

In families where meat is found to be too ex- 
pensive, peas and beans can be largely substituted 
and with good results. 

Fresh vegetables and fruits, while not rich in 
nutritive properties, contain salts and acids neces- 
sary for the proper composition of the blood and 
other fluids, and without which the blood soon be- 
comes impoverished, and the disease known as 
scurvy soon develops. 



50 Practical Hygiene 

Fruits contain eighty-five per cent, or more of 
water, but a small amount of protein, and some 
mineral matter, chiefly the citrates and tartrates 
of potassium. The principal nutritive element in 
fruit is sugar. 

The value of certain foods to the consumer is 
influenced by individual needs, or such conditions 
as occupation, environment and climate, and his 
ability to digest and assimilate them. 

The quantity and quality of food required de- 
pends on such conditions as age, sex, size or 
weight, occupation and climate; children, in pro- 
portion to size and weight, require more food than 
adults, as both maintenance and growth must be 
provided for. Generally speaking, females re- 
quire less than males, and small people, less than 
those of large proportions. A laboring man re- 
quires more food and of different quality than the 
sedentary or brain- working man. 

More meat, fat and carbohydrate is required in 
cold climates or cold weather than in warm. 
More food is consumed than is required by a ma- 
jority of people, who eat too much of what they 
like and not enough of what they should. 



PEEPARATION OF FOOD. 

THE preparation of food is a most interesting 
and important subject for consideration, 
both from a physiological and economic 
point of view. 

Cooking certainly exercises an important influ- 
ence on health, and the subject in connection with 
good health, physical improvement and household 
economics is deserving of the most considerate at- 
tention. 

The chief object of cooking is to render food 
more easily digested; proper cooking also ren- 
ders food more palatable and wholesome. Cook- 
ing also destroys germs or bacteria that exist in 
meats and vegetables which, if not killed by heat, 
are capable of exciting disease. 

Typhoid fever and other intestinal troubles 
have been communicated by eating salads made 
from uncooked and contaminated fruits and vege- 
tables. All fruits and vegetables are capable of 
contamination in various ways, and should always 
be thoroughly washed before being eaten. Celery 
and radishes, if to be eaten raw, should be washed 



52 Practical Hygiene 

in several waters and be scrubbed with a stiff 
brush. 

Cooking will not render safe the eating of 
tainted meats of any kind. Ptomaines are ex- 
tremely poisonous substances, developing in meats 
allowed to hang too long, or in potted or tinned 
foods which have undergone putrefactive changes. 
The practice of allowing fowl, game or any meat 
to hang for the development of flavor is extreme- 
ly dangerous, as the flavor desired by some mis- 
guided tastes comes close to the border line of 
putrefaction, when the poisonous ptomaines be- 
gin to develop. The ability to judge correctly as 
to age and quality of meats and other food pro- 
ducts, is knowledge of much value. Different 
methods of cooking have different and definite ob- 
jects in view, which should be well understood. 
Economy is largely conserved by proper cooking, 
especially of meats. Improper cooking of meat 
renders it indigestible and results in loss of its 
nutritive elements. 

In broiling or roasting meat, it should be im- 
mediately subjected to heat intense enough to 
coagulate the albumen in its exterior, thus insur- 
ing the retention of its juices within, after which 
cooking should be continued slowly with a heat 
of less degree, and in order that it be not burned 
or dried, it must be subjected to frequent basting 
with hot fat. Beginning roasting or broiling with 



Practical Hygiene 53 

a low temperature results in loss of palatable and 
nutritive juices, and a dry, unpalatable and indi- 
gestible food. The same principle is to be ob- 
served in boiling meats. If a rich and nutritious 
broth is desired, place the meat in cool water and 
gradually raise its temperature, when the juices 
and extractives of the meat will be slowly but 
surely dissolved out and leave a meat of little 
value ; while if a nutritious and palatable meat is 
desired, plunge it at once into boiling water, and 
afterward slowly continue the cooking. Poor 
cooking and improper methods of handling, keep- 
ing and preparation of food have been responsible 
for a good share of acute and chronic digestive 
troubles. The subject deserves the most careful 
and scientific study and investigation, and should 
become a part of the compulsory instruction given 
to all girls in the public schools. 

Young women by becoming students of domestic 
science and household economics, can accomplish 
vastly more good than in the study of political 
equality, or in the organization of women's clubs. 



DIET. 

DIET is tlie proper mixing of various food 
materials in such proportions and quanti- 
ties as are needed for growth and mainte- 
nance of normal strength and energy. 

Diet obviously exercises an important influence 
on health. 

An intelligent dietary must vary to meet the re- 
quirements of age, condition of life, climate or en- 
vironment, and involves something of a knowledge 
of the constituents or composition of foods, their 
nutritive value and amounts necessary to main- 
tain health and strength under various conditions. 
It must also take into account individual peculiari- 
ties and susceptibilities, and the fact that in the 
matter of eating, each individual must in a meas- 
ure be a law unto himself, both economically and 
physiologically. 

With these facts in view, the difficulty of formu- 
lating rules of diet applicable to all classes be- 
comes manifest. 

Eules in effect that diet should consist of whole- 
some food and be consumed slowly and well masti- 



Practical Hygiene 55 

cated in amounts sufficient but not excessive, can 
be made of general application. 

The study of food chemistry and its practical 
and physiological application has still much to 
accomplish, and further research and experiments 
will doubtless render possible an economy in diet 
that can be practiced with much advantage in the 
promotion of health and long life. 

Man being an omnivorous animal can obtain 
nourishment from a great variety of food. 

Former experiments in the nutrition of adults 
have seemed to produce identical results on diets 
of wide variation. Likewise, observation teaches 
that the laboring man can maintain health and 
strength on dissimilar diets. 

While many important matters relating to food 
and diet are not definitely settled, experience and 
observation have established certain facts which 
must be given due consideration. 

A great majority of people, especially those in 
good circumstances, eat too much, and thus many 
lives are shortened or made miserable. 

Unquestionably more trouble comes from exces- 
sive eating of meat than from excessive eating of 
any other food. 

Excessive eating, and especially excessive meat 
eating, throws an extra and unnecessary burden 
on the excretory organs, and often excites diges- 
tive troubles, rheumatism and kidney disorders. 



56 P r actio al Hygiene 

Excessive eating also brings a burden of flesh 
and predisposes to inactivity and degenerative 
diseases. 

The laboring man should have more food, espe- 
cially of meat, than the brain worker or man of 
sedentary habits, but as a rule, eats less and en- 
joys better health, but he will do well on meat 
once daily, if he will eat a liberal amount of oat- 
meal, peas and beans. He always needs a liberal 
amount of starchy foods, sugar and fat, but re- 
quires less fat in summer than in winter. 

The chief reason why the laboring man can 
digest and assimilate both more and a richer and 
coarser food than the sedentary man, is that his 
greater exercise favors and increases his excre- 
tory functions. 

The brain worker needs starch or sugar and 
fat, but should eat little beef, veal or pork, and 
instead, should eat fish, fowl and lamb. 

Brain workers, to have clear heads, must have 
good digestions, hence they should avoid all food 
that can not be readily and easily digested, among 
which are fried meats or fried eggs, pork and 
beans, uncooked salads or vegetables, nuts, too 
much uncooked fruits, rich puddings and hot 
breads of all kinds. 

More carbohydrate or sugar and fat are re- 
quired in cold weather or in cold climates than in 
warm. 



Practical Hygiene 57 

In summer the amomit of meat and fat needed 
is very small, and fruits, green vegetables and 
milk meet the essential needs of the body better 
than meat and potatoes. Milk, cheese and eggs 
should be largely substituted for meat, and salad 
oil for lard and butter, hence there is economy as 
well as safety in a proper summer diet. 

In middle life we should prepare for old age by 
conserving the vital forces, by the practice of 
temperance and abstinence in eating and drinking. 

We should steer clear of the table d'hote diet, 
avoid rich and conglomerate foods and big night 
dinners. 

Eemember that a light breakfast or judicious 
fasting helps to counteract the effect of a big din- 
ner, that over much of condiment irritates and 
impairs taste and digestion. That in advanced 
life, with lessened activity and no demand for de- 
velopment, the amount of food may be the mini- 
mum, and that little or no meat is needed; and 
that in old age, milk, sugar and fats are needed, 
and the diet should approach that of childhood. 

The amount of food required by a healthy adult 
is just enough to maintain the body in health 
without a gain or loss of weight. The amount 
should be no more and often not as much as nature 
craves. While instinctive desires in choice and 
quantity of food may be given some consideration, 
they are not always to be trusted, as appetite may 



58 Practical Hygiene 

be perverted by faulty education or habits of life. 

The amount and quality of food required de- 
pends also on capacity or demand on the indi- 
vidual for exercise or work. 

The complete digestion of an ordinary meal re- 
quires four or more hours and the digestive or- 
gans should have periods of rest between meals, 
if continuous good work is to be expected of them, 
hence there should elapse at least five or six hours 
between meals. 

Breakfast should be taken soon after rising, 
and dinner, or the most substantial meal, at mid- 
day. If dinner is taken at night, it is best that a 
little time should elapse before going to bed. It 
is better, however, to eat and go to bed at once 
than to go to bed hungry. 

The first meal after extreme fatigue should be 
light, as digestion proceeds slowly at such times. 

Water enters into the combination of all the 
body tissues and is necessary for the maintenance 
of a proper lubrication, solution or dilution and 
consistency, and thus renders possible the process 
of digestion, assimilation and excretion. It is 
also a distributor of heat, and regulates tempera- 
ture by its properties, permitting absorption and 
evaporation. 

The amount of water required daily by adults 
is about four pints, varying somewhat according 
to size or weight of body, exercise and atmospheric 



Practical Hygiene 



59 



conditions. A glass of water should always be 
taken on rising in the morning, midway between 
breakfast and dinner and between dinner and 
supper, and before retiring at night. About a 
glass of water is also required with or immedi- 
ately after each meal, as digestion is aided by a 
moderate degree of dilution. Water, however, 
should not be used to wash down food, which 
should always be thoroughly masticated and 
moistened with saliva before it is swallowed, as 
the thorough comminution and ensalivation of 
food is most essential to good digestion. 



DIGESTION AND ASSIMILATION. 

DIGESTION is the process by which the food 
in its passage through the stomach and 
intestines is rendered soluble, or changed 
so as to be readily absorbed. 

Assimilation is the process by which food ele- 
ments are utilized by the human economy after 
digestion is complete, to build up, repair or main- 
tain structure or supply heat and energy. 

A normal nutrition, growth or functional activ- 
ity can only be maintained by good digestion and 
assimilation. Foods vary much in the ease and 
readiness with which they may be digested, like- 
wise different individuals vary in their ability to 
digest the same food ; therefore individuals must 
exercise care in the selection of such food as ad- 
vice and experience teach they can readily digest. 
A proper nutrition and good health do not depend 
on the amount of food consumed, but rather on the 
quantity of nourishment that is assimilated. 

Notwithstanding the importance of the matter 
of quantity and quality of food, the average man 
seems to know and care more about the proper 



Practical Hygiene 61 

feeding of his horse or dog than about what he 
eats himself. 

Digestion is influenced much by such bodily 
conditions as fatigue, exercise, emotions, indo- 
lence, etc., and good digestion depends not so 
much on what we eat as the manner of eating. 
Poor teeth are often responsible for digestive 
troubles. 

Indigestion is said to be an imperfect solution 
of food, and may be due to overeating, eating too 
rapidly, to improper food or to functional weak- 
ness of the digestive organs. Any excess of food 
consumed beyond physiological requirements is 
detrimental to health. In those having good 
digestion it brings a burden of flesh or fat. In 
those of ordinary or feeble digestion it overtaxes 
and deranges the digestive functions and impairs 
nutrition. 

Excess of food increases the work required of 
the excretory organs and may thus induce disease 
of the liver, kidneys or other organic troubles. 

Undigested food may undergo putrefactive 
changes, causing distress, pain, irritations or in- 
flammatory conditions in the intestinal tract, and 
may be accompanied by nausea, vomiting, head- 
ache and other functional troubles, according to 
its degree of severity and time of continuance. 

Most digestive troubles in summer are due 
either to excess of food or failure to select food 



62 Practical Hygiene 

adapted to conditions of weather or occupation. 
While the treatment of indigestion usually re- 
quires simply a regulation of the diet, the ele- 
ments entering into its causation are sometimes 
complex and require the attention of a physician 
for diagnosis and treatment, either dietetic or 
medical. 



INFANT AND CHILD FEEDING. 

THE highest mortality of life is during the 
first year. This fact is well substantiated 
by statistics. In rural districts about one- 
fifth of all children born, die during the first year. 
In the larger cities the death rate has at times 
reached one-third. 

Even among infants born under favorable con- 
ditions and environment, and afforded the normal 
nourishment of healthy mother's milk, the death 
rate is large in the first and second years. Among 
those bom under unfavorable conditions and de- 
prived of their natural food, the death rate often 
assumes enormous proportions. 

A large majority of infants dying during the 
first year of life, die either from improper food or 
their inability to digest or assimilate it. 

I desire to make impressive the fact that an 
infant deprived of its mother's milk has its 
chances for life and health materially lessened; 
that the substitution of cow's milk or any arti- 
ficially prepared food, when the mother is capable 
of nursing her infant, is a most dangerous, if not 
criminal, action. 



64 Practical Hygiene 

The problem in infant feeding is not simply to 
preserve life during the first and most perilous 
year, but to adopt the method which shall pro- 
mote its healthy and normal growth, as on this 
healthy and normal development, largely depend 
the capabilities and usefulness of the individual, 
physical, mental and moral, in after life. 

The infant may be nourished by three methods. 
It may be nursed by its mother, by a wet nurse, 
or be nourished by a substitute food, either the 
modified milk of the cow or by one or more of 
many proprietary products so largely advertised 
for infant feeding. 

The first named is nature 's own and by far the 
superior method, and while mothers in good 
health and properly environed and situated in life 
should usually be required to nurse their infants, 
there may be contra-indications for so doing. 

Generally speaking, to obtain the best results in 
maternal feeding, the mother should not only be 
well, but strong and vigorous. It occasionally 
happens, however, that women who are far from 
vigorous and are in fact seemingly delicate, have 
an abundant supply of good milk, and can, if prop- 
erly nourished themselves, successfully and sat- 
isfactorily nurse their children. 

Other factors than normal conditions of 
health on the part of the mother are important to 
ideal conditions for nursing. 



Practical Hygiene 65 

The motlier should be willing to nurse her in- 
fant and be able to devote requisite time to this 
particular duty. She must also be able and will- 
ing to regulate her time for work and recreation 
or exercise, so as not to interfere with regular 
hours for nursing, and if necessary to exercise 
self denial in the matter of her own diet. A happy, 
even temperament on the part of the mother is ad- 
vantageous. She should not be subject to any 
unnecessary trouble, anxiety or overwork, which 
may render the milk of uneven quality or quantity, 
and thus be a source of danger or discomfort to 
the child. Some mothers have such small or de- 
pressed nipples, as seriously to interfere with the 
child's getting sufficient nourishment. Such con- 
ditions will often try the patience and ingenuity 
of both mother and nurse, but it is their duty to 
make every effort and try every kind of device 
for assisting the child before deciding to abandon 
nursing. 

Cracked or excoriated nipples are serious ob- 
stacles to nursing, and the first indication of such 
troubles always calls for the immediate attention 
of the physician, whose prompt treatment will 
usually give immediate relief. 

Maternal feeding is not only best for the child, 
but under normal conditions is beneficial to the 
mother. 

For the first three days after confinement, there 



66 Practical Hygiene 

is but little secretion in the breast and the child 
needs only what the breast contains, and until the 
flow of milk becomes well established, which is 
usually about the end of the third day, the infant 
should be placed to the breast only every six or 
eight hours. It is well however, to give the child a 
teaspoonful of warm water two or three times 
daily. As soon as the breasts have become well 
filled the infant should be nursed every two or 
three hours during the day, if awake. It may be 
allowed to sleep three hours during the day if it 
will, but not longer except at night. 

A definite hour should be set for the daily morn- 
ing bath, and from that hour ^ the hours for 
nursing. If the bath is to be given at nine A. M. 
nurse the infant at seven and again immediately 
after the bath and so on until bed time or until ten 
or eleven P. M. It should be nursed but once be- 
tween this time and seven A. M., and after the 
fourth month it may go through the night or from 
ten P. M. until seven A. M. without feeding. 

The importance of regular habits as to feeding 
and care of the child, can not be over estimated. 

Careful attention to such details favor the 
health, comfort and good disposition of the child, 
and in the end save the mother and nurse much 
trouble and annoyance. 

The mother should never cease nursing because 
she suspects her milk is of poor quality, unless 



Practical Hygiene 67 

advised to do so by her physician, and then not 
until several chemical analyses have been made 
and the milk thus proven poor. 

Mother's milk does not look as rich as cow's 
milk. It looks more watery and is, for this rea- 
son, sometimes unjustly condemned. 

Mothers suffering from tuberculosis should 
never nurse their infants. 

Premature weaning is usually necessary when 
the mother is attacked by acute diseases as pneu- 
monia, typhoid or scarlet fever. 

Pregnancy occurring during the nursing period 
certainly calls for weaning, but if the mother be 
strong, weaning may be gradual and nursing may 
be continued for a few weeks with no bad results. 

The character of mother's milk is sometimes so 
changed by the return of menstruation as se- 
riously to interfere with the infant 's nutrition and 
render a change of food necessary. 

If the child is nine months old and strong, I 
usually advise weaning on the appearance of 
menstruation, but the advice of the family physi- 
cian should be taken in each individual case. 

Mother's milk may occasionally be so unfavor- 
ably affected by her eating indigestible foods or 
acid fruits as to cause digestive disturbances in 
the infant. Exercise has a favorable influence on 
the secretion of milk and mothers should be en- 



68 Practical Hygiene 

couraged to take daily exercise out of doors as 
soon after confinement as safety will permit. 

It frequently happens to nursing women not in 
vigorous health, that while the supply of milk may 
be of good quality, it is persistently deficient in 
quantity, and it becomes necessary to decide 
whether nursing must cease entirely or whether 
it must be supplemented by other food. Experi- 
ence favors the latter plan as giving the infant 
the best chances, especially during the earlier 
months of life. 

If the infant can be nursed for even two or 
three months and weaning can be gradual, sub- 
stitute feeding becomes less hazardous. 

The diet of the healthy nursing mother need not 
essentially differ from the normal at any other 
time. It should, however, be bountiful and nour- 
ishing. It may be necessary to vary the diet in 
given cases, and on the advice of the physician, 
to increase the quantity of milk or improve its 
quality. The tendency, especially early in the pe- 
riod of lactation is to eating too much meat and 
solid food and not using enough of liquids, thus 
increasing the total solids in the milk of the moth- 
er, to a point beyond the ability of the infant to 
digest. 

If the mother's milk seems deficient in quantity, 
there is nothing better for her to take to increase 
the flow, than a plentiful amount of warmed cow's 



Practical Hygiene 69 

milk in addition to her regular diet. Beer, ale or 
other stimulants should not be taken by nursing 
mothers. 

Under ordinary, normal, and healthful condi- 
tions the child should be weaned at the end of 
twelve months. While some women can doubtless 
continue nursing for a longer period without detri- 
ment to themselves and apparently satisfactory to 
their infants, there is rarely good reason for so 
doing, for after the twelfth month, mother's milk 
is not sufficient food for the corresponding stage 
of the infant's development, so if nursing is con- 
tinued beyond this period, the child must be fed 
other food, if it is to be properly nourished. It is 
usually best to avoid weaning during the months 
of July and August. 

"Weaning should, if possible, be gradual. Begin 
with substitute feedings alternately, omitting the 
breast feedings one by one, until you are sure the 
substitute food is agreeing with and nourishing 
the child satisfactorily. 

In the artificial feeding of infants, a rational 
procedure is to select the milk available, nearest 
approaching in its various constituents to that 
of the human, this is of course cow's milk. 

Cow's milk differs from the human only in the 
proportion of its various component parts, thus 
you will appreciate the necessity of modifying it 
by adding to or taking from it certain parts of its 



70 Practical Hygiene 

various constituents, so as to make the modified 
product correspond as nearly as possible to moth- 
er's milk. 

As it is becoming customary for physicians to 
prescribe definite formulas for the modification of 
cow's milk, the principles involved should be thor- 
oughly understood by nurse and mother. Cow's 
milk contains practically one-half more albumi- 
noids than mother's milk, it is thus evident that 
the first step in modification is to dilute the cow 's 
milk one-half. 

As cow's milk and mother's milk contain prac- 
tically the same proportions of fat, we find that 
cow's milk diluted one-half contains only one-half 
the proper amount of fat, which must then be 
added. To make easy and accurate both these 
steps in modification, the milk should be procured 
in bottles, bottled at the farm, and after the cream 
has risen, with a siphon draw oif one-half the con- 
tents of the bottle from the bottom, thus leaving 
all the cream or top milk, which when diluted with 
an equal quantity of water, contains practically 
the same proportions of fat and albuminoids as 
found in mother's milk. 

Mother's milk contains more sugar than cow's 
milk, thus you will see the next step in modifica- 
tion will be the addition of sugar. The amount 
required is about a level teaspoonful of sugar to 
eight ounces of the diluted top milk. 



Practical H y g i e n e 71 

Mother's milk is alkaline, cow's milk is not dis- 
tinctly so, and thus requires the addition of lime 
water, about a teaspoonful of which should be 
added to each eight ounces, and we then have a 
modified cow's milk closely approaching in com- 
position that of the human. 

As soon as possible after the milk is delivered 
in the morning, enough should be prepared for the 
day's feeding, and enough for one feeding placed 
in as many bottles as the infant will require for 
the day. The bottles should then be stoppered 
with rubber corks and placed in the cooler until 
required for use, when they may be warmed by 
placing in a basin of warm water. It will be found 
necessary occasionally to vary the modification of 
milk to meet the requirements or digestive capa- 
bilities of different infants, by changing the pro- 
portion of fat, by adding more water, or possibly 
by addition of cereal gruels. 

If there is any doubt as to the purity and whole- 
someness of the milk used or if facilities for 
keeping are not good, it may be best to sterilize 
the milk. To do this, fill as many feeding bottles 
as will be required for the twenty-four hours with 
the requisite amount of the modified milk required 
for a feeding, then stopper them with sterile cot- 
ton wool and place in the sterilizer, and keep the 
temperature at from 168 to 170 degrees, F., for 
thirty minutes, after which remove the bottles 



72 Practical Hygiene 

and place them in a cooler until needed for use. 

Sterilizing at this temperature (168 degrees, 
F.), is called pasteurization. This temperature 
continued for a half hour is sufficient to destroy 
disease germs. A higher temperature or steriliz- 
ing milk by boiling injures its nutritive value. 

Fresh uncooked milk is always to be preferred 
for infant feeding, when it can be procured with 
a certainty of its freshness and purity. Milk for 
infant feeding or for any purpose should not be 
kept about the house or in a cooler in open vessels. 

Milk left by the infant should never be used for 
a second feeding. 

Nursing bottles and nipples should after using 
be washed in soap and water and boiled for fifteen 
minutes before being used again. 

At the age of eight or nine months, a teaspoon- 
ful of oat or barley jelly should be added to each 
bottle of milk, and at twelve months the child 
should be weaned from the bottle and required to 
take its milk from a spoon ; at this time, it should 
be able to digest whole milk. It should not be al- 
lowed to drink from a cup, as, in this way, milk is 
taken into the stomach too rapidly for good diges- 
tion. From one to four years of age, the child 
should have five meals daily. From fourteen to 
eighteen months old the child may have boiled 
rice and milk once daily, and once or twice daily 
a small crust of bread. When eighteen months 



Practical Hygiene 73 

old, it may have a little butter on its bread and a 
small baked potato once daily. At twenty months 
it may have a soft boiled egg every third day, also 
beef juice, mutton or chicken broth, cereals and 
milk. 

Until the child is four years old, milk should 
constitute the larger part of its food. Fresh bread 
should never be given children, cake or other 
sweets destroy the appetite for proper food and 
disturb digestion. After the third year, the child 
may have a baked apple occasionally, but other 
fruits should be withheld until the child is four 
years old. 

At four years the child may begin to eat the 
more easily digested vegetables, and have meat 
once daily ; beef, mutton or chicken only should be 
allowed. Egg and meat should not be allowed at 
the same meal at this age. 

At five years the diet may begin to approximate 
that of the adult. A glass of milk with meals is 
desirable from this time on, but one glass is 
enough, as more destroys the appetite for other 
necessary food. 

Milk is lacking in mineral elements and for this 
reason is not suitable as an exclusive food after 
the period of infancy. The lack of mineral in milk 
is made up in oat meal, hence a breakfast of oat 
meal and milk with the addition of an egg is an 
ideal breakfast. 



74 Practical Hygiene 

Unquestionably, growing children are better off 
without either tea or coffee at any time. Children 
should have the heaviest meal at mid-day and 
should as a rule have meat only at this time. 

The development and maintenance of good 
teeth in children require that they should be exer- 
cised daily. They should, therefore, not be allowed 
to live exclusively on soft foods that require little 
or no mastication, and should be required to eat 
with at least two meals daily either a slice of dry 
toast or hard crust of bread. Children should be 
encouraged in the use of butter and olive oil and 
be allowed sugar in liberal quantities. Eating 
quantities of cake, nuts or fruits should not be 
allowed between meals. They should have some 
kind of fruit daily, either with dinner or luncheon. 

The feeding of children is important, because on 
proper food depends the proper growth, health 
and capacity for usefulness in after life. A fre- 
quent cause of degeneracy or ill health in children 
is improper food or improper feeding. 



FOOD ADULTEEATION. 

COMMENTING on the subject of food adul- 
teration, Paul Pierce, Supt. of Food Ex- 
hibits at the St. Louis Exposition, said: 
*^ Dyes and impurities vie with poor substances 
masquerading as good to make every dinner table 
a menace to health. ' ' 

Food frauds have certainly been prevalent in 
recent times, and until States or Municipalities 
realize their importance, and assume the responsi- 
bility of a practical and systematic inspection of 
food products, there will be safety only in the use 
of such foods as can be prepared in the home. 
Nearly every article of prepared food is capable 
of adulteration, the ever increasing number and 
complexity of composition, renders the matter of 
official supervision or inspection no easy task. 

Properly the responsibility for the inspection 
and supervision of manufacture of all manufac- 
tured articles of food designed or sold for export 
or interstate use, should devolve upon the National 
Government. 

States should also exercise the right of inspec- 
tion, and compel a competent and systematic in- 



76 Practical Hygiene 

spection by State and Municipal authorities of all 
articles of food, drink or drugs manufactured or 
sold within their jurisdiction, also an inspection 
of all butcher shops, cold storage plants, markets, 
groceries, bakeries and candy shops, pharmacies, 
restaurants or places where any drinks or foods 
are manufactured or sold. 

It should require no argument to demonstrate 
the importance and value of food inspection, and 
that, like other sanitary work, should be in the 
hands of competent men, trained especially for the 
work and not subject to the vicissitudes of politics. 

Pure food and drug laws should compel official 
chemists to analyze from time to time all prepared 
food and drinks, and publish for the benefit of the 
public the results of analysis of all articles ana- 
lyzed, with names of manufacturers and vendors 
thereof. 

The extensive application of chemical preserva- 
tives in the manufacture or handling of perish- 
able foods is a noteworthy feature of modern 
times. The almost universal use of various pre- 
servatives is clearly shown by the reports of in- 
vestigating officials of many governments repre- 
senting most advanced civilization. 

The only safe methods of food preservation to- 
day, are absolute cleanliness in handling and 
preparation, refrigeration, hermetical sealing in 



Practical Hygiene 77 

vacuo, the use of wood smoke, common salt, sugar 
and vinegar. 

The Massachusetts State Board of Health in the 
summer months of 1898, 1899 and 1900 examined 
5,169 samples of milk, and found 179 samples con- 
tained preservatives ; of this number 142 contained 
formaldehyde and 130 boracic acid. They also 
found table sauces containing no vegetable matter, 
various fruit jellies and preserves made of gela- 
tine, glucose and chemical color and flavor, having 
no relation to fruit it was supposed to represent, 
and pickles made green by preparations of copper. 

Various combinations of Formaldehyde, Borax, 
Boric acid. Salicylic acid, Bi-carbonate of Soda 
and other chemicals have been advertised and 
largely sold as harmless food preservatives under 
such names as ** Preservaline '' *^ Freezine " 
*^ Iseline '^ &c., &c., with glowing testimonials as 
to the advantages and benefits accruing from their 
use. One is offered for preserving butter, one for 
meat, one for cider, one for wine and another for 
sausage. 

Under date June 7, 1906, Thomas MacFarlane, 
chief Analyst at the Laboratory of the Inland 
Eevenue Department at Ottawa, Canada, reports 
on the analysis of fruit preserves, that but 53 out 
of 182 samples were unadulterated; that many 
samples contained glucose, salicylic or benzoic 
acid and were dyed. That 65 out of 110 farmers 



78 Practical Hygiene 

and dairy-men admitted the use of preservatives, 
that out of 4,251 food samples examined, 1,659 
were found to contain preservatives of different 
kinds. 

Among those examined and found containing 
preservatives were cream, butter, bacon, ham, 
sausage, jam, lime and lemon juice, temperance 
drinks and malt liquors. While there is no doubt 
that some of the antiseptics used in the preserva- 
tion of foods may be taken in small quantities and 
for a short time by many adults in vigorous 
health, their dietetic use is certainly prejudicial 
to good digestion and good health, and will doubt- 
less in children and in many adults result in much 
harm. Some people have a peculiar susceptibility 
to the action of certain drugs and, in such people, 
small doses produce symptoms, which in others 
would have no effect. Who knows that obscure 
cases of indigestion or malnutrition have not been 
due to antiseptics in food. 

Salicylic acid is especially dangerous to the 
aged or to those suffering from irritation or in- 
flammatory conditions of the digestive or urinary 
tracts. 

I earnestly plead and advise that until such a 
time as we have National and State laws prohibit- 
ing food adulteration and preserving of food by 
antiseptics, and a competent State and Municipal 
inspection insuring safety against a violation of 



Practical Hygiene 79 

law, that, as far as possible, all foods be prepared 
in the home, not only as a matter of safety but also 
as a matter of economy. 



jiii 



li 



PUEE MILK. 

ITS VALUE AS A FOOD. HOW TO PRODUCE AND KEEP IT. 

COWS milk is a necessary article of food. 
There is no other food in such daily and 
universal use, and on which we depend so 
much in all the critical periods of life. It contains 
all the elements of a perfect food, and needs mod- 
ification in the proportions of its various elements 
only to make it the best possible substitute for 
mother's milk, for infant feeding. All people 
should use daily two or three glasses of milk. 
Children should be required to drink milk daily 
until fully developed. It is especially useful in old 
age, and a necessity in illness at any period of life. 
It is an economical as well as a most nourishing 
food. 

In view of the value of milk and its general use 
as a food, and the absence of any substitute ap- 
proaching its value, the necessity of a pure and 
wholesome supply becomes manifest. 

The value of milk depends on its purity. If 
milk is impure, it is laden with bacteria and soon 
imdergoes putrefactive changes. Impure milk is 
both disgusting and dangerous, and causes disease 



Practical Hygiene 81 

and death, more especially so in children. Im- 
provement in methods of producing and handling 
milk and its more general use for infant feeding, 
has largely reduced infant mortality in the last 
decade. 

Of all substances used for daily food, there are 
none so susceptible of contamination as milk. 
When it comes from the udder of a healthy cow it 
is practically sterile, but without the exercise of 
care on the part of the milker, its contamination 
immediately begins, and its value as a food is di- 
minished or destroyed. 

Owing to well-known carelessness in producing 
and handling of milk, many people are deterred 
from its use. The general adoption of modern 
improved methods of production and transporta- 
tion will surely result in a very largely increased 
consumption. 

By pure milk, should be implied the properly 
handled and kept product of healthy and well 
cared for cows. To produce pure milk, it is first 
necessary to have healthy cows and have them 
kept stabled and cared for under sanitary con- 
ditions. 

A cow sick with any disease, should be removed 
from the herd and quarantined. A place remote 
from the herd should always be provided for sick 
cattle and for parturition. During parturition 
and for a week after, cows should have a clean 



82 Practical Hygiene 

box stable with plenty of bedding, and this stable 
should be thoroughly cleaned before another cow 
is put in it, for cows are very susceptible to germs 
causing blood poisoning, milk fever, garget, &c. 

Diseases of cattle, especially tuberculosis, are 
communicable and feadily transmitted from one 
animal to another and may be transmitted to man. 

The bacillus of tuberculosis may be in the milk 
of cows having general tuberculosis or tuberculo- 
sis of the udder, or the germ may find its way into 
the milk in the form of dust from manure or the 
nasal discharges of cattle having the disease. 

It is well known that cattle may have tubercu- 
losis and not show the disease by physical signs; 
and that the milk of such cattle may become in- 
fected, and that by drinking such milk, the bowels, 
lungs or lymphatics of young children or certain 
adults may become infected, causing disease or 
death by tuberculosis. 

The only way that the disease can be detected 
in cattle before it becomes well advanced, is by 
the application of the tuberculin test. 

The tuberculin test will not injure healthy cat- 
tle, and should be applied to all dairy herds at 
least once a year. New cows should not be added 
to the herd until they have passed the test. 

Cattle having the disease should be immediately 
slaughtered or removed from the herd, and not 
allowed to occupy the same barn, or run in the 



Practical Hygiene 83 

same pasture with healthy cattle, or next to them, 
or to in any way come in contact with healthy 
cattle. 

The natural food for cattle is grass, and cattle 
should be allowed to run in pasture whenever pos- 
sible. In the winter, when giving milk, they 
should have plenty of clean bright hay with grain 
of some kind. I think well of alfalfa, but do not 
recommend the feeding of ensilage to cows giving 
milk. Fresh or dried corn fodder is good at any 
time. The more and the richer the milk the cow 
gives, the more food she needs. The better she is 
fed, the more and better milk she gives. 

The character of milk and its keeping qualities 
may be unfavorably influenced and rendered 
harmful, by improperly feeding the cow such food 
as turnips or cabbage, or too large a portion of 
ensilage. 

An abundant supply of pure water is necessary 
for cattle at all times. They should never be per- 
mitted to drink from or to stand in stagnant pools 
or polluted streams ; by so doing their udders be- 
come dirty, and thus filth or disease germs may 
find their way to the milk pail. 

The stable must be sanitary, in other words, it 
must be well drained, lighted and ventilated, with 
at least 400 cubic feet of space per cow. Concrete 
floors and drains are good if plenty of bedding is 



84 Practical Hygiene 

used. Manure, dirt, dust or cobwebs or litter 
must not be allowed to accumulate in or about the 
stable. 

Cattle should not be fed hay just before milking, 
and care must be taken not to raise dust in the 
stable by feeding, sweeping or other operations 
just before milking. 

It is a matter of economy to use plenty of bed- 
ding, as by so doing, liquids are absorbed and 
much valuable fertilizing material is saved, the 
comfort of the cattle improved, and filth kept from 
their bodies and out of the milk pail. During the 
stabling season, cattle should be required to take 
daily exercise outside the stable. 

The cows must be kept clean, the bodies, legs 
and udder should be brushed daily, and long hair 
on the belly and udder kept clipped. The udder 
should be rubbed with a damp cloth before each 
milking. 

If the best results are to be obtained, that is, 
if milk is to be produced containing the least pos- 
sible number of bacteria, it is essential that spe- 
cial milking stables be provided, in which the cows 
are to be kept only while they are being milked, 
and in which they must not be fed, and the stables 
used for no other purpose. These stables should 
be built of brick, stone or cement with concrete 
floors, which could be flushed with water after 
each milking. 



Practical Hygiene 85 

HEALTH OF EMPLOYEES. 

No person or employee liaving consmnption, or 
living in a house with or coming in contact with 
others having typhoid, scarlet fever or dip- 
theria, should be permitted about the cow stables, 
or have anything to do with the handling of milk. 

The milkers should wear clean washable suits, 
and wash and dry their hands before milking. 

Observation and experience has shown that the 
premature souring of milk is too often due to un- 
clean utensils, as cans, pails, strainers, &c., that 
they have not been properly washed or sterilized. 
To cleanse milk utensils or bottles properly, they 
must first be rinsed in clean cold water, and then 
placed on a tray containing hot water and wash- 
ing soda and thoroughly scrubbed with a brush, 
and again rinsed in clean water. Such treatment 
will cleanse the articles from visible milk or dirt, 
but not from the souring bacteria ; they will still 
smell sour ; it is then necessary to immerse them 
in boiling water for a half hour, or place them in 
a tight box and apply live steam for thirty min- 
utes, and here they should be allowed to remain 
until wanted for use. It should go without saying 
that water used about the dairy should be of un- 
questioned purity. 

The milk pail is an important element in the 
production of pure milk. The pail should have a 
cover, with an opening one third the size of the 



86 Practical Hygiene 

body of the pail, and will thus reduce to a mini- 
mum the possibility of dust or dirt getting into 
the pail, from the stable or body of the cow, dur- 
ing the process of milking. 

It has been demonstrated that bacteria may 
find their way into the teat-duct, and if it is de- 
sired to produce milk with the lowest possible 
bacterial count, two or three draws of milk from 
each teat should be discarded ; this procedure 
favors the keeping quality of the bulk of the prod- 
uct and the discarded milk may be fed to calves or 
swine. 

By following the foregoing suggestions, pure 
and wholesome milk will be produced. The next 
problem is to maintain its purity and wholesome- 
ness until it reaches the consumer. 

The purest milk produced under the most care- 
ful conditions may speedily become unfit for food, 
if improperly or carelessly handled or kept, but 
with a requisite knowledge of its peculiarities and 
the exercise of reasonable care, it will keep sweet 
and wholesome for several days. 

After milk has been drawn under proper pre- 
cautions into clean vessels, the first essential to 
ensure its keeping qualities is rapidly cooling it to 
50 degrees F. out of contact with air. It should 
then be immediately bottled, the bottles sealed and 
maintained at the above mentioned temperature 
till delivered to the consumer. 



Practical Hygiene 87 

The practice of running the milk over an aera- 
tor located in the stable or in the open air should 
be condemned. Aeration should be practiced only 
in the milk room with all possible sanitary ar- 
rangements and facilities for cleanliness. Milk 
may be satisfactorily cooled by straining it into 
cans, and immersing them in ice water. Milk 
should not be bottled until cooled. 

What we have before said regarding the cleans- 
ing of milk utensils or receptacles, should be ap- 
plied with religious care to bottles. Bottled milk 
should be packed in cases holding twenty or more 
bottles, and kept surrounded by ice until delivered 
to consumers. 

The practice of peddling milk over a large 
route, by dipping it from a large can for individ- 
ual customers in dirty and dusty streets, is very 
objectionable. Milk tickets should never pass 
from one consumer to another, but should be given 
out in cards, from which they may be torn and 
only used once. 

Bottling milk at the farm insures to the con- 
sumer, not only cleanliness in handling and deliv- 
ering, but his proper proportion of cream; while 
if dipped from a large can, the milk taken from 
the bottom of the can may be deficient in cream. 

The care of milk after delivery to the consumer 
is a matter of much importance. If milk is kept 



88 Practical Hygiene 

in open vessels in a refrigerator, it will readily 
absorb odors from meats and vegetables. 

The best containers for milk are vessels of 
porcelain or glass. Tin dishes can be used if clean 
and bright. Pure milk will soon sour without 
proper care, and it is unfair to blame the producer 
for conditions for which he is not in the least re- 
sponsible. 

If open pitchers or pails are left on the door- 
step in the early morning and remain a prey to 
dust, insects, cats and dogs, the consumer must 
not blame the producer if this milk soon sours. 

The best means of preventing the too early 
souring of milk, is absolute cleanliness, cold and 
heat. If milk has been properly produced and de- 
livered to the consumer, he should have no trouble 
in keeping it sweet at a temperature of 50 degrees, 
for from 24 to 36 hours. 

Pasteurization and sterilization of milk has 
been much practiced of late as a means of its pres- 
ervation and killing of germs, with which it may 
be infected. 

To pasteurize milk, it must be heated to 76 de- 
grees F. and maintained at that temperature for a 
half hour. This treatment will destroy almost 
all germs with which milk may be infected. 

To sterilize milk, it must be heated to the boiling 
point. This will destroy all germs present. 

A disadvantage of pasteurizing or sterilizing 



Practical Hygiene 89 

milk is that it renders it less digestible and nutri- 
tious than raw milk, and its use, if long continued, 
will in some infants cause degenerative disease. 
Pasteurization is to be preferred, as it is less 
harmful to the nutritive properties of milk than 
sterilization. 

If milk of unlmown sources or of doubtful pur- 
ity must be used for infant feeding, it should 
certainly be pasteurized. We prefer, however, to 
know that milk is drawn from healthy cattle, and 
kept free from contamination, than to feel we are 
eating cooked disease germs rendered harmless by 
heat. 

Milk pasteurized at the farm or milk station, 
may be recontaminated, therefore, if pasteuriza- 
tion is to be done at all, it should be done in the 
house where the milk is to be consumed. 

Various chemicals have been used to prevent 
the souring of milk, but there is no known chem- 
ical preservative or antiseptic, that can be used 
for this purpose, without rendering it harmful and 
dangerous as a food. 

It is difficult to tell by its appearance that milk 
is pure. Legally pure milk must contain certain 
proportions of fats and other solids. After stand- 
ing several hours, cream should rise naturally, 
and if of normal proportions should form at least 
one-eighth of the total volume. 

The milk from some cows, especially Jerseys, 



90 Practical H 1/ g i en e 

will yield a mucli larger volume of cream. No 
sediment should appear in the bottom of the jar 
or glass containing pure milk. The yellow shade 
of milk is due to its fat, and as a rule the more yel- 
low the shade or color, the richer it is in fat. 

Some cows naturally give poor milk, or milk 
deficient in fat, therefore, a careful and intelligent 
dairy-man will not buy a cow until he has assured 
himself by proper tests, that her milk is of good 
quality, or at least up to legal standard. The milk 
of a good cow should yield at least four per cent 
of fat. Milk is heavier than water — its specific 
gravity varies from 1,029 to 1,033. Departure 
from the standard, due to skimming or watering 
milk, may be shown by an instrument called the 
lactometer, but accurate as the instrument is, it 
can only show specific gravity. 

STANDARD FOR MILK. 

One hundred pounds of milk contains essential- 
ly 87 pounds of water, 4 pounds of fat, 5 pounds 
of milk sugar, 3.3 pounds of casein and 
albumen and 0.7 pounds of mineral matter. The 
fat varies in quantity more than any other ele- 
ment. 

The usual legal standard requires from three to 
three and a half per cent of fat, and from nine to 
nine and a half per cent of solids not fat, making- 
twelve to thirteen per cent of total solids. It is 



Practical R y g i eyi e 91 

evident that it is solid matter and not water that 
gives value to milk. 

If cream is removed specific gravity is in- 
creased. If water is added specific gravity is de- 
creased. Thus if the specific gravity is increased, 
skimming is suspected, while if specific gravity is 
low, watering is suspected. Consequently if the 
intelligent but unscrupulous dairy man has re- 
moved a portion of the cream, and thus increased 
the specific gravity, he knows that he must add 
water, in order that the inspector's lactometer 
may read correctly. It is therefore, plain that the 
official use of the lactometer is of little value, and 
that the only accurate method of testing milk is 
that by which the total fat and other solids are ex- 
tracted, and their proper proportions determined. 
No municipal laboratory is complete unless equip- 
ped with all the necessary apparatus for testing 
milk and no milk inspector is competent, who does 
not thoroughly understand its use. 

If consumers of milk would take more interest 
in the production of milk, by occasionally visiting 
the farm and inspecting the stable, cattle, dairy 
and habits of attendants as to cleanliness and 
methods of handling and keeping milk, and re- 
quire of their producer or dealer a semi-annual 
certificate of health from a reputable veterinarian, 
showing that after a careful examination of his 
cows, including the tuberculin test, they were 



92 Practical Hygiene 

found in good health, they would undoubtedly get 
served with good milk. 

The method of producing milk naturally in- 
fluences its cost to the producer and its value to 
the consumer. The extra cost of good stock, of 
good buildings and equipment, the best methods 
of handling and delivery, veterinary inspection, 
bacteriological and chemical analysis, are large 
items of expense for the producer. 

It is reasonable that the price of milk should de- 
pend on its quality. It is also unreasonable that 
milk containing three per cent of fat, should sell 
for the same price per quart, as milk containing 
five per cent of fat. It also costs more to produce 
rich milk than poor milk, and besides four quarts 
of rich milk may contain as much or more food 
value than five quarts of poor milk. 



PEESONAL HYGIENE. 

WHILE the domain of public hygiene is to 
safeguard the health of municipalities or 
communities by the official isolation of 
infectious diseases, the destruction or disinfection 
of infectious matter, the protection from contami- 
nation of ice, water and food products, the protec- 
tion from pollution of soil and air, the regulation 
of noxious trades and dangerous occupations, the 
safe construction and ventilation of buildings, the 
regulation of the manufacture and sale of intoxi- 
cating liquors and in fact the regulation or sup- 
pression of any influence detrimental to the pub- 
lic health; individuals owe a duty to themselves, 
their families and the public, in the matter of per- 
sonal hygiene, and of so conducting or regulating 
their habits of life as to promote a normal and 
healthy existence. The subject is one of vital im- 
portance, it deserves the attention of every indi- 
vidual, and should have a place in the curriculum 
of all elementary schools. 

Briefly summarized, personal hygiene implies 
personal cleanliness, proper clothing, regulation 
of diet, avoidance of excesses, systematic work, 



94 Practical Hygiene 

rest, exercise and recreation, and the maintenance 
of a salubrious environment. 

It takes but a casual observation of the habits of 
some of the lower animals to demonstrate that in 
the matter of cleanliness they have an inherent in- 
telligence of a higher order than that of many 
human beings. 

The skin has important excretory functions of 
constant action, and frequent bathing is neces- 
sary, both for the healthy performance of these 
functions and the removal of noxious products 
that are constantly accumulating thereon. 

Bathing is an important factor in maintaining 
and promoting health, and a most valuable cura- 
tive agent in disease. 

Various baths and methods of application have 
different objects in view, either as hygienic or 
curative agents. 

For purposes of cleanliness warm baths are 
best. Every healthy adult should take at least two 
warm baths each week, before retiring at night, 
and some people should take them nightly. Hot 
baths are of much aid in reducing muscular sore- 
ness, the result of violent or excessive exercise, 
and aid often in the treatment of insomnia. 

Hot baths are best taken at night, just before re- 
tiring as they increase the pulse and respiratory 
action and cause more or less perspiration and 



Practical Hygiene 95 

general relaxation demanding a period of rest and 
contributing to the promotion of sleep. 

A cold bath is best taken in the morning. It 
has a decidedly stimulating effect upon the nerv- 
ous system, and after a vigorous rub down gives 
a feeling of increased vigor and exhilaration, good 
for the beginning of the day's work. In the ab- 
sence of a tub or shower a cold sponging answers 
an excellent purpose. 

Cold baths should not be taken by people in ad- 
vanced years or by those suffering from organic 
disease. After sixty years of age the morning 
bath should be tepid or at a temperature of sev- 
enty degrees, F. 

An excellent substitute for the morning bath, 
especially for those who are advanced in years, is 
the morning use of the flesh brush. Every por- 
tion of the body should be vigorously brushed un- 
til the skin is thoroughly reddened. If the person 
is not in good muscular condition it is well to have 
the brush applied by another. 

The hygienic objects of clothing are to conserve 
the body temperature and the protection of the 
body from the effects of cold, wind, moisture or 
external injury or discomfort. 

In extremely hot weather or in hot climates the 
thinner and lighter the garment or its fabric and 
the lighter the color, the better. 

A good rule is to dress at all times so as to be 



96 Practical Hygiene 

either comfortably warm or comfortably cool and 
avoid being uncomfortably cold. Those people 
who are necessarily subjected to sudden changes 
of temperature should wear flannel underwear. 
No one should sleep in under garments worn dur- 
ing the day. Clothing should be as light as possi- 
ble and give required warmth. Boots and shoes 
should fit the foot. Well fitting foot wear will re- 
quire no breaking-in. The use of high heeled 
shoes causes weakness of the arch of the foot, and 
by causing the foot to drive forward into the shoe 
develops corns and makes it impossible to walk 
gracefully. 

Excesses to which man is prone are many. The 
most vicious and common are doubtless those in- 
curred in the satisfaction of appetite. It may be 
for food beyond the need of sustenance and 
strength, resulting in an overwork of digestive 
and excretory organs and consequent retention of 
poisonous elements, or an accumulation of super- 
fluous fat ; or it may be for stimulants in the form 
of intoxicating liquor or noxious drugs. For best 
results in the promotion of health and long life 
individuals should strive to eat as little as is nec- 
essary to maintain a normal weight and strength. 
The daily or frequent use of any form of stimu- 
lants by healthy adults is prejudicial to health. 
Stimulants cause an exhilaration of mind and all 
the body functions which is always followed by a 



Practical Hygiene 97 

corresponding period of depression, which is det- 
rimental to the general well being and calls for 
more stimulants. 

The so called temperate nse of stimulants, as 
usually applied, is a moderate use, but any use by 
healthy people is excessive use, inasmuch as no 

use at all is best, and any use for them is harmful. 

ft. 

WORK AND EXEECISE. 

The maintenance of a healthy condition of mind 
and body requires daily and regular work or spe- 
cial exercise that shall bring into action both mus- 
cles and brain. Exercise is necessary, not alone 
for the development of muscular strength, but to 
stimulate a healthy performance of digestion, and 
all other bodily functions. 

Many of the labors and pursuits of life furnish 
physical exercise in plenty. Other pursuits give 
the brain sufficient exercise, but do not exercise 
the muscles. 

People whose occupation requires little muscu- 
lar effort, must take some sort of exercise daily. 
Those occupied within doors should, if possible, 
exercise in the open air. 

For outdoor exercise, walking, horseback rid- 
ing, golf, ball, rowing, hunting and fishing answer 
an excellent purpose. 

For people who can not get the desired out door 
exercise, indoor gymnastics or so called physi- 



98 P r actic al H y gien e 

cal culture exercises are an absolute necessity. 

Every home should be equipped with some kind 
of mechanical exerciser and all people not using 
their muscles at work should use it daily. Such 
exercises as can be combined with pleasure give 
the best results. 

Eest of mind and body is essential for recupera- 
tion of energy and repair of waste. It is generally 
conceded that the average person requires at least 
eight hours sleep, besides a daily period of recrea- 
tion and diversion from the monotony of daily 
labor, cares of business and mental worry. The 
monotony and grind of certain vocations or posi- 
tions in life are doubtless responsible for many 
nervous breakdowns. To combat these tendencies, 
liberal vacations and complete change of scenery 
and environment are often necessary. A certain 
amount of absolute rest is needed, but people who 
are overworked must be careful not to overplay, 
and thus deprive themselves of necessary rest and 
relaxation. 

Poor and diseased teeth are often responsible 
for obscure conditions of ill health. Good diges- 
tion requires that food shall be thoroughly masti- 
cated before it is swallowed. In order to masti- 
cate food thoroughly one must have good teeth. 
If the teeth are good they may be preserved by 
eating properly. Teeth like other body structures 
must have exercise or they will decay. Some kind 



Practical Hygiene 99 

of food should be eaten daily that requires thor- 
ough mastication. 

The mouth and teeth should be thoroughly 
cleaned after each meal. The dentist should be 
visited at least once each year for an examination 
of the teeth so that defects may be remedied be- 
fore serious damage is done. 

It is a part of personal hygiene to maintain a 
healthful environment, to have clean and well ven- 
tilated habitations or places of occupation, to 
breathe fresh air uncontaminated by dust, smoke 
or other pollution. 

LOFe. 



THE HYGIENE OF PREGNANCY. 

A FIRST essential for normal and favorable 
pregnancy is physical fitness. This implies 
more than a normal development and 
healthy performance of all functions on the part 
of both prospective parents; their personal and 
family physical developments should not be dis- 
proportionate. Parentage on the part of either 
man or woman suffering from certain diseases or 
degenerative tendencies is always deplorable; 
may even be little less than criminal. I almost 
feel like advocating it as a subject for legislative 
enactment. I will mention three general factors 
that influence favorably the period of pregnancy 
and its final termination. They are hygiene, 
psychical and medical. 

The hygiene of pregnancy must begin in the 
childhood of woman, where only the foundation of 
a vigorous constitution, and a normal develop- 
ment can be attained by proper food, clothing, ex- 
ercise, &c. ; details and necessities of which are 
now well understood by most intelligent people, 
but most sadly neglected in the rearing of young 
women. 



Practical Hygiene 101 

It is not uncommonly remarked by the passing 
generation of women that the child-bearing women 
of the present time are having troubles unknown 
to their mothers, or, in other words, the child- 
bearing powers of women are degenerating, and 
they wonder why their daughters are not as vig- 
orous as were their mothers. 

Such factors as the comforts, requirements, and 
indolent tendencies of modern civilization, unsan- 
itary environment, occupation, &c., are, of course, 
each responsible for a share of the trouble. It is 
certain that trouble in many instances during 
pregnancy or parturition, arises from neglect in 
some essential particular or period during the 
physical development of women. 

It is essential that women be taught an early 
and better understanding of themselves, of the 
physiology of the functions of ovulation and ges- 
tation, a better appreciation of the advantages of 
a vigorous physique, and the methods of attaining 
it under adverse circumstances. 

Providence has ordained that child-bearing 
should cease before the beginning of retrogarding 
changes, and the wisdom of this provision is ob- 
vious, inasmuch as the mother plays the stronger 
part in foetal development, and maternal charac- 
teristics, physical and psychical, are more fre- 
quently and positively transmitted. Some will 
doubtless take exception to the latter statement; 



102 Practical Hygiene 

it, nevertheless, coincides with my observations. 

Undoubtedly the most favorable time for child- 
bearing is early in the child-bearing period, after 
full physical and mental development has been at- 
tained. The state of pregnancy is not noted for 
improving the condition of unhealthy women; 
neither does it confer immunity from diseases to 
which non-pregnant women are liable; in fact, I 
think the general statement, that disease tenden- 
cies are augmented or accelerated by that func- 
tion, is fully warranted. It is admitted that ex- 
ceptions occasionally occur. 

Beginning with the onset of pregnancy, there 
occur such various alterations of structure and 
functions, as to require a hygienic regime peculiar 
to that condition, which must be rational, and 
varied according to individual temperament, en- 
vironment, former habits, and physical peculiari- 
ties. 

Special topics to be mentioned in the discussion 
of the hygiene of pregnancy are: Food, drink, 
clothing, bathing, exercise, rest, and care of the 
breasts. 

The diet of healthy women with no unfavorable 
manifestations, need not be very much varied 
from the ordinary. As a rule, meat should be 
eaten sparingly. Whenever a deficient elimina- 
tion of urea is found, or albuminuria exists, meat 



Practical Hygiene 103 

should be excluded from the diet, and a liberal 
amount of milk substituted in its stead. 

All cereals, fresh vegetables and fruit, milk and 
olive oil can always be taken in abundance. 
Whole wheat bread should form a portion of the 
diet of all healthy women. Candies and sweets 
generally should be avoided. The diet should be 
so selected, if possible, as to induce without other 
aid, a daily evacuation of the bowels. Of greatest 
aid in this particular will be found the liberal use 
of apples and orange juice. 

If morning or daily nausea or vomiting exists, 
meals must be light and taken four times daily, the 
last meal shortly before retiring at night. When 
the appetite is excessive, as it often is, it is well 
to stop eating a little short of full satisfaction. 

Coffee and tea must be used in moderation; 
beer, wine, and other stimulants should be entirely 
prohibited. Water may and should always be 
taken in abundance. For the prevention of morn- 
ing nausea or vomiting, a cup of warm water, to 
which has been added a pinch of salt, taken a half 
hour before rising is worth more than all the 
drugs of the pharmacopoeia. 

Eegarding clothing, the principal thing to bear 
in mind out of the ordinary is to so dress as to 
avoid undue compression of the abdomen. This 
can only be perfectly done by suspending gar- 
ments from the shoulders. Woolen underwear 



104 Practical Hygiene 

should always be worn during the entire period. 
Many women complain of weakness in the back 
or of lack of support on leaving off their corsets. 
Corsets may be loosely worn with safety and com- 
fort until the end of the fourth month. After that 
period, abdominal supports or belts, properly 
gored and made with back and side stays, similar 
to the corset, will be found of advantage to those 
accustomed to tight lacing or having pendulous 
abdomens. 

In observance of the hygiene of pregnancy, 
there is nothing of greater importance than a 
plentiful amount of exercise taken daily and sys- 
tematically. Women in moderate or impecunious 
circumstances usually find sufficient exercise in 
their household duties, but do not go enough into 
open air. For women not obliged or inclined to 
do household duties, a strict regime of daily exer- 
cise should be observed. Of all methods of exer- 
cise advocated or devised for the pregnant woman, 
there is none so valuable as walking. Exercise is 
essential for proper muscular development; it 
materially favors assimilation and elimination, 
and the proper performance of all functions. 

The pregnant woman, undoubtedly, should have 
more rest and sleep than is necessary in the non- 
pregnant state. A half hour's rest in the recum- 
bent position, after eating, favors digestion and 
tends to prevent nausea. 



Practical Hygiene 105 

Frequent bathing promotes functional activity 
of the skin and the general well-being. A tepid 
bath should be taken at least twice each week. Eo- 
bust women can, with advantage, take a daily 
sponge bath. Those who cannot endure the daily 
sponge bath should indulge in a liberal daily use 
of the flesh brush. Sitz baths and douches should, 
as a rule, be avoided. 

An important matter never to be neglected is at- 
tention to the breasts. After pregnancy has ad- 
vanced to the fifth month, the nipples should be 
bathed frequently with a solution of boric acid, 
fluid extract of quercus alba and glycerine, and 
the breasts covered with a pad of sterile gauze or 
cotton. Undue pressure or manipulation of the 
nipples must be avoided. By these simple meth- 
ods, fissure of the nipples and mastitis can almost 
surely be prevented. It is well-known that certain 
bacteria may find their way to the mammary 
gland through the normal milk ducts and that 
mastitis may be due to glandular infection 
through a local lesion of the nipple, hence the ne- 
cessity of its careful aseptic toilet. 

It is, no doubt, a matter of considerable specu- 
lation as to how far psychological factors influence 
favorably or otherwise, the pregnant woman or 
the foetus in utero, but I think we must recognize 
that such factors have a considerable degree of 



106 Practical Hygiene 

importance, and should give them our serious at- 
tention. 

Owing to the varying temperaments and suscep- 
tibilities, the physical and psychical peculiarities 
of women, their varied environment and condi- 
tions of life, pregnancy and the anticipations of 
prospective motherhood produce a wide differ- 
ence in the condition of individual minds. Emo- 
tional susceptibilities are almost always increased, 
and mental impressions are more pronounced ; for 
this reason the pregnant woman deserves the 
most considerate attention on the part of friends 
and associates. Some women can and should at- 
tend church and places of public amusement and 
recreation, while it is best for others to keep in 
comparative retirement, or in the companionship 
of considerate friends. Profound mental impres- 
sions or nervous shock may, unquestionably, pro- 
duce structural changes in the ovum, and from 
such influences the pregnant woman should be pro- 
tected to the utmost possibility. 

After a healthy woman has conceived, there is 
nothing so conducive to her future well-being as to 
be satisfied with her condition, coupled with a de- 
termination to do her utmost to bring to its full- 
est possibilities the new life just beginning. Un- 
fortunately, this proposition is too frequently re- 
versed, with results fatal to either one or both 



Practical Hygiene 107 

lives, or disastrous to the health of the unhappy 
survivor. 

Every pregnant woman should, early in her 
pregnancy, consult her physician for thorough 
general physical examination. After this exam- 
ination, it is not then best to take for granted that 
pregnancy is advancing favorably, but frequent 
subsequent examinations should be made for the 
determination of irregularities of position, or 
other possible complications. 

Pregnant women are subject to disorders which 
may be traced directly to their new condition, or 
to a deviation from the normal in structure or 
function, existing prior to the inception of preg- 
nancy. These disorders may have been so insig- 
nificant as to have been unrecognized before that 
time, and needed only the added stimulus or de- 
pressing influence of the new function, to bring 
them into prominence. Disturbances directly due 
to the existence of pregnancy are most frequently 
the result of mechanical influences, or pressure, 
nervous reflexes, and nutritive changes. Without 
discussing theories as to causation of disturbances 
from pressure, it is sufficient to say that the pres- 
sure of the gravid uterus frequently interferes 
with the functions of the bladder, kidneys, and 
bowels, also with the circulation, and sometimes 
with respiration. 

For the relief of disturbances due to pressure. 



108 Practical Hygiene 

there is nothing of more avail than systematic ex- 
ercise, and the assuming of such positions or pos- 
tures as will relieve pressure on the parts affected. 
Assuming the so-called knee-chest position several 
times daily will often give much relief, and favor 
return circulation. Assuming the recumbent posi- 
tion, with limbs and hips elevated, several times 
daily, is also advantageous. Women in advanced 
pregnancy should not attempt to sleep while lying 
on the back. 

Nervous reflexes are various, the more common 
and noteworthy being nausea and vomiting. This 
reflex seems more common in women of nervous 
temperaments, and in first pregnancies. It is 
often, I believe, the result of pre-existing displace- 
ment, flexion, or adhesion following inflammatory 
processes. Neuralgias are common, and are, I am 
sure, often due to lack of exercise and consequent 
deficient elimination. 

As a rule, all neurotic tendencies are aggra- 
vated, and for their treatment, properly applied 
hygienic and dietetic measures deserve foremost 
consideration. 

It too frequently happens that the physician's 
attention to the pregnant woman is restricted to 
the actual period of labor. This I well know is 
not always the fault of the physician but it has 
been too often such. While it is certain that preg- 
nancy is a normal function in a healthy and vigor- 



Practical Hygiene 109 

ous woman, and not in any degree a morbid state, 
it must be admitted that a large proportion of the 
pregnant women of to-day are not, strictly speak- 
ing, in a physiologically healthy condition before 
the beginning of pregnancy ; therefore, after mak- 
ing due allowance for the fact that this should be 
a perfectly healthy state, we must, I think, admit 
that most pregnant women require professional 
advice if not medical treatment. 

Unquestionably, pregnancy is occasionally the 
exciting cause of nutritive changes, which may 
vary from an exaltation to a marked depression 
of normal nutritive functions, but when such 
changes are pronounced and unfavorable, there 
will often be found a predisposing environment, 
condition of life, or inherent personality. 

There has been a quite common notion, even 
among an intelligent laity, that the use of various 
decoctions, or empirical medicines, during preg- 
nancy, would influence, in a sort of general way, 
its course and termination. A safe procedure in 
the pregnant condition is to take no drug or medi- 
cine except for a specific purpose, and on the ad- 
vice of a physician. 

The greatest danger to which pregnant women 
are liable is from deficient urinary excretion. 
This danger seems greatest to women in their first 
pregnancies, and to women inclined to corpulency. 
Trouble from this source can almost universally 



110 Practical Hygiene 

be avoided by systematically observing the 
amount of urine voided each twenty-four hours, 
and requiring its frequent and careful quantita- 
tive analysis for urea, by a competent physician. 
A woman suffering from this condition demands 
active treatment and careful watching during the 
remaining portion of her pregnant condition. As 
a rule, treatment should be more hygienic and 
dietetic than medical. As exercise favors elimina- 
tion, such patients should be required to walk as 
much as possible in the open air. I have had preg- 
nant women walk from three to five miles daily 
with the greatest benefit and no discomfort. 

Massage and other well-known methods of in- 
door exercise are worthy adjuncts of treatment 
for those who cannot be made to walk. Healthful 
activity of the skin can be promoted by frequent 
bathing, and the free use of the dry brush. In- 
asmuch as meat eating entails the necessity for in- 
creased excretion of urea, it should be largely, and 
perhaps, wholly, excluded from the diet. Milk 
should always be taken freely by these women. 
The more serious cases demand an exclusive milk 
diet. As increasing the amount of urine by ex- 
cessive drinking of water unquestionably pro- 
motes the elimination of urea, soft or distilled 
water should be consumed freely. Digestion 
should be maintained as perfect as possible, and 
a free daily action of the bowels not neglected. 



Practical Hygiene 111 

The strengtli, health and vitality of the infant 
at birth, as well as its future growth, its develop- 
ment, nervous temperament and capabilities in 
after life, are strongly influenced by maternal 
conditions during pregnancy. 

These facts should be quite sufficient to impress 
on pregnant women their sacred responsibility, 
and on expectant fathers a due regard and consid- 
eration for the mental and physical condition of 
his wife during this most important period. 

The foregoing is taken from an article contrib- 
uted by the Author to the Medical Record and 
published July 19, 1902. 



HEREDITY. 

HEREDITY is a factor influencing largely 
the life of all human beings. 
The forces of heredity begin their 
work with conception, and have done their best or 
worst at birth. They have their origin in one or 
more preceding generations, and are surely to be 
carried on to posterity, influencing the character 
and destinies of individuals, communities and 
nations. 

The law of heredity is positive and unques- 
tioned, and the possibilities of hereditary influ- 
ences, place upon parents a powerful responsibil- 
ity for the normal, physical, mental and moral de- 
velopment of children, and ^^ on the governing 
bodies of states and municipalities, a duty in the 
care of physical and moral degenerates. ' ' 

It is not more wonderful that mental qualities 
and traits of character should be transmitted, 
than that life, form and organization should take 
the same descending course. Doubtless the 
stronger elements of heredity emanate from the 
last preceding generation. There are, however, 
notable exceptions. 



Practical Hygiene 113 

The force of maternal hereditary transmission 
is, doubtless, stronger than paternal. This fact 
seems to be clearly shown by the statistics of pub- 
lic institutions and hospital reports. 

Galton has estimated the average of ancestral 
traits transmissible as follows : ^ ^ The parents to- 
gether contribute one-half the total heritage ; the 
four grandparents one-fourth; the eight grand- 
parents one-eighth ; the sixteen great great grand- 
parents one-sixteenth, and all of the remainder of 
the ancestry one-sixteenth. ' ^ 

Those born with an alcoholic diathesis, or with 
brain and nervous system of deficient quality, will 
succumb to intemperance or crime, unless sup- 
ported by the constant influence of parents, teach- 
ers and friends, and the continual exercise of the 
power of self control. 

The great majority of inebriates, and moral and 
physical degenerates have an unfavorable her- 
edity. 

Mental and moral hereditary traits of character 
can be largely influenced, modified or overcome, 
by education and environment. 

Actual disease is not inherited except in rarest 
instances, but physical and psychical characteris- 
tics, peculiarities and defects, baneful tendencies 
or disease tendencies, are certainly transmitted 
from parent to offspring. The regulation or cor- 
rection of these tendencies requires intelligent and 



114 Practical Hygiene 

earnest cooperation on the part of parents, guar- 
dians and friends, and necessitates, on the part of 
their unfortunate possessors, a constant exercise 
of discretion, temperance in all things, and the 
most persistent attention to all matters pertaining 
to hygiene, both personal and general. 



MOEAL HYGIENE. 

HYGrlENE is as applicable and of quite as 
much importance to the moral, as to the 
physical side of life. 

The practical application of the principles of 
hygiene imply simply, correct living and right 
doing. 

No man is serenely happy who has wronged his 
fellow-man or has violated the laws of Nature, 
God or Man; and, not being happy, he does not 
long enjoy good health. 

Eight doing promotes happiness. Happiness 
and contentment bring both health and wealth. 
Wrong doing has its fruition in mental and physi- 
cal disorder. 

Wealth is nothing, compared to physical and 
moral health. 

The world much needs to-day higher ideals of 
character, less law and better morals; a public 
press divorced from subsidy and with a keener 
sense of its privileges and opportunities to edu- 
cate and cultivate higher ideals of justice, truth, 
morality and virtue; an individual standard of 
rectitude that insures obedience to the spirit of 



116 Practical Hygiene 

law, and an abhorrence of the indifference of so- 
ciety, dishonest business methods, sensational 
journalism and lax laws permitting indiscretions, 
injustice and crime, without retribution or rebuke. 

There seems to be quite general approval of a 
recent statement, *^ There is need of a searching 
of the heart, serious reflection and good resolu- 
tions on the part of the Legal Profession, which is 
in danger of a general mistrust on the part of the 
people, because of a too devoted service to selfish 
interests, involving too often an evasion of law 
and miscarriage of justice. '' They must not lose 
sight of the fact that truth and justice and the 
general public welfare is of more importance than 
large individual incomes. 

Much good has been accomplished for the pub- 
lic welfare by the unselfish and devoted interest 
the Medical Profession has taken in hygiene and 
general sanitation. The same earnest and de- 
voted work by the Legal Profession in the inter- 
ests of truth and justice would accomplish just as 
much for the public good, and at the same time im- 
prove the confidence of the people, in a profession 
that should be looked up to with esteem and trust. 

The greed for gain, influence, position and po- 
litical power, dulls the conscience and blinds the 
sensibilities of many men to right and wrong. 

Painful, demoralizing, and menacing our na- 



Practical Hygiene 117 

tional prosperity and civic reputations, are the too 
common instances of ill-gotten gain through finan- 
cial or political connivance or conspiracies, which 
have been modernized by the appellation of ^ ^ high 
finance '' or ^' graft. '' 

Graft is everywhere rampant. In every line of 
life and business there is a crying need for a high- 
er order of morality, and an extinction of respect- 
able scamps. 

In the political world there is great need for a 
higher morality. Men are needed, honest and 
courageous, less tolerant of public extravagance, 
who will enter politics for the good that they can 
do, rather than for what they can get out of it for 
themselves, who will recognize the personal and 
general advantages of civic purity, official honor 
and uprightness, and will strive fearlessly to cor- 
rect the evils resulting from the too frequent and 
sudden acquisition of large fortunes, independent 
of legitimate enterprise or industry. There may 
be such men in politics to-day, but their numbers 
are far too small for highest aims and best results. 

Frederick Farrar once said, '^ The prayer of 
every great community should be, ^ God, give 
us men. ' ' ' 

^^ What constitutes a City, '^ ^' What consti- 
tutes a State, '' was well answered by Sir Wm. 
Jones. 



118 Practical Hygiene 

"Not high raised battlement or labored mound, 

Thick walls or moated gates, 

Not cities proud, with spires or turrets crowned, 

Not bays and broad armed ports 

Where, laughing at the storm, rich navies ride, 

Not starred and spangled courts, 

No ! Men — High minded men — 

Men — who their duties know. 

And know their rights, and knowing dare maintain." 

Moral courage is not to be promoted by law, and 
has not been brought to the desired standard by 
modern education. It does seem, however, that 
good results would follow a constant instilling 
into the minds of the rising generation in the pub- 
lic schools, the advantages of a high standard of 
moral character and a love of truth, genuineness, 
patriotism and righteousness. In the education 
of young men, there is no quality that should re- 
ceive such careful consideration and cultivation 
as moral character, the essential elements of which 
are justice and truth, and ever the same in diverse 
social conditions, and without which there is no 
real peace, joy or comfort of hope shedding God's 
light on the shadowy paths of life. 

While recognizing the advantages of education, 
we must bear in mind that genius and knowledge 
without high purpose and moral principle may be 
even dangerous. While higher education, af- 
fluence and industrial progress should promote 
happiness, health and morality, there too often 
comes, with these conditions, vicious obligations 



Practical Hygiene 119 

to greed, ambition or pleasure, having their frui- 
tion in lower morality and higher mortality, or at 
least a tendency that way. 

While the State has long recognized its duty in 
promoting education, it has been remiss in an im- 
portant feature. The State must educate physi- 
cally, mentally and morally, but the last should 
be of first importance. Home influences are too 
often deficient or vicious. The State can com- 
pel attendance at school, but not at church. If 
the State will hold prominently and constantly be- 
fore its wards in the public schools, the highest 
ideals of character, patriotism and nobility of 
purpose, they will learn to admire the best in hu- 
man conduct, and live and act accordingly. Then, 
if sustained by a consistent Christianity, the in- 
dividual is safe from the withering heat of lust, 
ambition, strife and dishonesty. 



MOBAL HYGIENE OF THE PEESS. 

THE newspaper is a great educator. It has 
done and is doing a great work for human- 
ity. The power and influence of the daily 
press for good or evil is greater than any other 
human agency. It is therefore essential that its 
influence should be the best possible; yet people 
often remark that its influence for good should be 
greater than it is at present. 

Notwithstanding that the newspapers are in the 
hands of men of highest intelligence, they are too 
often dominated by political, selfish, or moneyed 
interests, curtailing their genius and dwarfing 
their good intentions. 

All newspapers are not bad. Many are good, 
and many of them might be better. 

' ' The newspaper represents public thought and 
feeling and action. It is a mirror that reflects 
mankind as it is. The world may look in it and 
see itself. The bad is there as well as the good, 
and more bad than good because truth requires it. 
If moral sentiment is there, it is because the moral 
sentiment of the public demands it. The pro- 
gressive newspaper must keep pace with public 



Practical Hygiene 121 

morals though it does not create them. The news- 
paper knows nothing of morality as its prime 
purpose/' 

The foregoing statements recently appeared 
editorially in a representative newspaper, and are 
therefore entitled to be received as a true state- 
ment of facts as to newspaper morality and moral 
teaching, and, '^ pity 'tis, 'tis true." 

Some newspapers represent so much of bad 
thought and feeling and action that it is possible 
that some of it is, by way of suggestion, the cause 
of bad thought and feeling and action on the part 
of individuals to whom it has never before oc- 
curred. 

It is good for mankind to look into the mirror 
that reflects that which is good, but good inten- 
tions are stalled by frequency of bad events, and 
most evil doing comes from evil seeing. 

Moral sentiment should not exist in the news- 
paper simply because the moral sentiment of the 
public demands it, but because it is right that it 
should be there. 

Because it interests or amuses a large portion of 
the public and sells the paper, is the reason why 
there is so much in the press of evil doing, forti- 
fied by the excuse that truth requires it. While 
a There is some soul of goodness in things evil, 
w^ould men observingly distil it out," it would be 
better, since ^' good, the more communicated, the 



122 Practical Hygiene 

more abundant grows,'' to portray less of evil 
and more of good, regardless of the baser element 
of public sentiment. 

Many people who can read have not the clear 
vision and sense of discrimination enabling them 
to distinguish between right and wrong, and from 
such people it is better to keep a part of the truth, 
if the truth portrays evil. 

Does the progressive newspaper keep pace 
with public morals'? If progressive, should it not 
lead the pace until it can be made to pay in dol- 
lars and cents? It is not expected that morality 
should be the prime purpose of a newspaper ; yet 
the thinking public has a right to demand that an 
influence so potent and far-reaching as the daily 
press shall have in it a moral element of large 
proportions. 



ELEMENTS OF BEAUTY. 

IT is entirely within the province of hygiene to 
promote the beautiful in nature and in per- 
sonality, and thereby increase happiness and 
enjoyment of life. 

"It is a plague to be too handsome a man," 

— Plautus. 

It is a plague for a woman not to be handsome. 

Every woman can and should be beautiful in 
some essential particular. It is a duty she owes 
to society, herself and her Creator. Beauty is a 
composite of mental, moral and physical elements ; 
thus, the elements of beauty are ' ' in the flesh and 
in the spirit which illumines the flesh, ' ' blended in 
varying degrees, and forming, fortunately, very 
many distinctive types, each of which has an 
ardent admirer. 

"True beauty dwells in deep retreats, 

Whose veil is unremoved 
Till heart with heart in concord beats, 

And the lover is beloved." 

— WORDSW^ORTH. 

Co-existing with the varying types and elements 
of beauty there is, providentially, a corresponding 



124 Practical Hygiene 

variation in ideals, one of which is always pre- 
dominant in the mind of the observer. 

" 'Tis not a lip, or eye, we beauty call, 

But the joint force and full result of all." 

—Pope. 

While a comely face is always good to look 
upon, it forms but a trifling element of true 
womanly beauty. 

Liberal measures of beauty are found in the 
contour of body and limb, in gracefulness of 
movement and carriage, in culture and activity of 
mind and body, rugged strength and vivacity, and 
the air of harmony in dress, all of which are more 
stable and capable of cultivation and preservation 
than facial beauty. 

"Her air, her manners, all who saw admired.*' 

— Crabbe. 

Intelligence represents a style of beauty much 
admired. Beauty charms the sight, but merit wins 
the heart. 

** 'Tis virtue that does make them most admired." 

—Shakespeare. 

The largest measure of beauty is found in the 
elements of character, the attributes of which 
formulate ^^ the spirit which illumines the flesh,'' 
and without which comeliness is insipid. Charac- 
ter is greater than intelligence. 



Practical Hygiene 125 

"What is beautiful is good, and who is good will soon 
be beautiful."— Sappho. 

Every woman should strive to look her best at 
all times, because appearance is a powerful factor 
in success, because she will be more pleasing to 
others, for personal and business reasons, and be- 
cause it will help her to gain everything in life 
worth having. 

"To be seventy years young is sometimes far more cheer- 
ful and helpful, than to be forty years old." — O. W^. Holmes. 

To keep young and retain the elements of 
beauty and vigor as long as possible or beyond 
the usual period, is commendable and worthy the 
effort. It prolongs your period of usefulness, 
promotes your own happiness and the pleasure of 
others, and thus becomes a duty. 

While to retain youthful vigor and appearance 
requires the practice of abstinence and temper- 
ance, and the exercise of economy in all the vital 
forces, it is not necessary to shirk the ordinary 
labors and responsibilities of life nor escape its 
annoying and vexatious problems, which are as 
necessary for the formation of muscle, mind and 
character as are clouds and rain for the develop- 
ment of all the verdure and beauties of nature. 

Even old age may retain the spirit of youth, 
and to have the spirit of youth is next to having 
youth itself. 



126 Practical Hygiene 

"As I approve of a youth that has something of the old 
man in him, so I am no less pleased with an old man that has 
something of the youth." 

"He that follows this rule may be old in body, but can 
never be so in mind." — Cicero. 

Dark complexions are as much admired as light. 
Every woman, dark or light, can have a clear 
complexion. 

Bad complexions indicate errors in diet or 
functional disorders, which require either regu- 
lation of diet or constitutional treatment, rather 
than the application of cosmetics. 

Intelligent women will avoid cosmetics and hair 
dyes, or so-called restoratives. Many of them 
contain lead in sufficient quantities to produce, if 
used as advised, serious constitutional disturb- 
ances, or neuroses, simulating rheumatic condi- 
tions and resulting often in permanent disability 
or serious impairment of health. 

It is better to grow fat, and look young, than it 
is to be thin and look old. Fat people can be made 
to lose flesh, not only without impairment of 
health, but usually with much benefit. Thin peo- 
ple can increase their flesh if they will, but for 
either object an intelligent physician should be 
consulted for advice or treatment. 

Stout women should bear in mind that most 
men admire a reasonable rotundity of form ; also 
that superabundant flesh cannot be removed by 
drugs without danger of serious impairment of 



Practical Hygiene 127 

bodily functions and permanent injury to health. 

Similar diets will produce in different people 
of like and normal proportions widely different 
results. One, having a good digestion and as- 
similation, and an even temperament, will grow 
fat, while, on the same diet, another, having de- 
fective digestive powers and a nervous tempera- 
ment, will grow thin. The one growing stout 
needs regulation and restriction of diet and a 
proper regime of exercise. The lean subject also 
needs a regulated diet, but one of different char- 
acter, supplemented by appropriate exercise and 
medical treatment. 

Beauty and health are promoted by sufficient 
sleep, proper diet and exercise, and by the appli- 
cation of massage and so-called physical culture 
exercises. 

Good health is the foundation of beauty. 



SOCIAL HYGIENE. 

THE SOCIAL EVIL. 

SOCIAL hygiene implies a correction of that 
condition of society that tolerates in every 
municipality what is known as the ^^ Social 
Evil/' otherwise known as prostitution; an evil 
as utterly unnecessary as it is deplorable and far- 
reaching in its effects. 

As a result of the social evil, there exists a class 
of diseases known as social or venereal diseases, 
which, unfortunately, are not confined to the orig- 
inal partners in vice. They are the most loath- 
some and their results the most appalling of any 
disease affecting the human race. They are a 
positive factor in swelling the death roll the 
world over. 

The lives of the many victims are made wretch- 
ed for years, and are often ended in the poor- 
house or insane asylum, or by joining the ranks 
of the suicide. I will not attempt to detail the 
frequent wrongs and sufferings of innocent 
women and helpless children. The sacred rela- 
tions of families in every class of society are in- 
vaded and disturbed by suffering, disunion or 



Practical Hygiene 129 

domestic tragedy. To children of infected par- 
ents are transmitted a poison which causes one- 
third to die within the first six months of life. To 
the remainder the sentence of death is extended 
to an indefinite but miserable period, or they are 
condemned to a wretched and degenerate life, to 
be transmitted even to the third and fourth gen- 
erations. 

Social diseases and their consequences involve 
the physical, moral and social elements of life. 
Their prevention thus demands the aid of social, 
moral, educational, sanitary and administrative 
measures. 

The subject is as disagreeable as it is impor- 
tant. Its shameful nature is, doubtless, respon- 
sible for the lack of interest and inaction of phy- 
sicians and sanitarians up to the present time. 
For the same reason disabilities from these dis- 
eases are under the ban of silence and secrecy, 
and thus physicians, only, know the appalling ex- 
tent of their existence, and the ignorant and dis- 
interested public does not know that a majority 
of childless marriages and premature births, a 
large part of infant mortality, early blindness, 
deafness and degeneracy, besides various nervous 
disorders and disabilities of adult life are due to 
this class of diseases. 

A careful consideration of the subject of the 
prevention of these diseases leads to the conclu- 



130 Practical Hygiene 

sion that their prevention can be effectively con- 
sidered only in connection with the restriction or 
regulation of prostitution, the most demoralizing 
element in the social life of municipalities. The 
evil is utterly unnecessary, inasmuch as perfect 
chastity for either sex, at any time of life, is en- 
tirely compatible with good and perfect health. 
The evil then is neither indispensable nor neces- 
sary, but must, doubtless, be tolerated until edu- 
cational conditions of society have undergone a 
considerable revolution, and people generally have 
a realizing sense of its degenerating physical and 
moral tendencies, and will cease to tolerate in 
men that which they will not countenance in 
women. 

It is held by many that the danger of the vari- 
ous venereal diseases is the best safeguard against 
them. But with this view of the question, and its 
consequent policy of inaction, we cannot coincide, 
for the results of long continued experience have 
proven its utter fallacy. 

The facts are that a majority of the yoimger 
victims are utterly ignorant of danger, thus 
showing the great need of more education on a 
subject that a feeling of false modesty has here- 
tofore prevented thinking people from giving the 
consideration it deserves. 

Municipal, administrative or restrictive meas- 
ures, where tried, have signally failed to be of 



Practical Hygiene 131 

practical value, largely because of the unfavor- 
able influence of politics and misguided public 
opinion. Intelligence will not tolerate the legal- 
ization of vice or immorality in any form, and 
prostitution should continue to be a violation of 
state and municipal law, but the communication 
of venereal diseases in the sexual relation should 
constitute a penal offense of general application. 

Sanitary officials should be given a limited au- 
thority to investigate and operate against the 
spread of venereal diseases, as well as other con- 
tagious or infectious diseases. 

I would suggest a law directing municipal sani- 
tary officials to investigate, by competent examin- 
ation, all who shall be convicted of certain penal 
offenses in any of the courts of law. The sug- 
gested law should provide a special penalty for 
the presence of venereal disease. 

The social evil and its consequences are not to 
be abolished by force or prohibitive legislation, 
but the time is ripe for some degree of restrictive 
legislation, or such legislation as shall demand 
that sanitary officials shall take cognizance of this 
class of contagious diseases, in such manner as to 
have some restrictive influence over known 
sources of contagion. 

Good results would follow the restriction of in- 
temperance, by the proper control of the sale of 
alcoholic stimulants and narcotic drugs, by en- 



132 Practical Hygiene 

forcing the law against sale to minors, and by 
keeping children, especially the parentless, off the 
street at night. 

The interests of humanity, virtue and morality, 
demand the union of legislative, moral and educa- 
tional measures for relief and protection. Of the 
three elements mentioned, educational measures 
are, doubtless, to be the most potent for good. 

The public mind must be awakened to the dan- 
gers involved and attain a higher moral standard, 
and some special care and instruction should be 
the young, lacking adequate home environment. 



PATENT MEDICINE AND DEUG 
CONSUMPTION. 

FEW people are aware of the enormous con- 
sumption of proprietary medicines, or stim- 
ulating drugs, such as opium and its alka- 
loids, also cocaine, hyoscyamus and chloral, inde- 
pendent of and contrary to the advice of the medi- 
cal profession. 

The results of habitual and unnecessary drug 
consumption are terrible and appalling in their 
magnitude, and in their insidious effects on the 
physical, mental and moral structure of their 
habitues. 

It is well known that most of the largely adver- 
tised and so-called tonics, bitters, sarsaparillas, 
restoratives, etc., contain large quantities of alco- 
hol, some nearly fifty per cent., and it has been 
charged that from their use chronic alcoholism 
has been produced, and it would seem that some 
of these preparations are in use largely because 
of the alcohol they contain, rather than because 
of their medicinal properties. 

I cannot advise too strongly against the unad- 
vised use by the laity, for any purpose, of any 



134 Practical Hygiene 

medicine or combination of drugs concerning 
wMch they have not a definite knowledge as to 
composition, strength, application or effect. 

The law compelling manufacturers or vendors 
of patent medicine composed largely of distilled 
liquors, to take out a license and give on the bottle 
the percentage of alcohol contained, will be a great 
blow to the trade, restrict and reduce the traffic, 
and thus be a great benefit to all humanity. 

Among the most pernicious and dangerous 
medicines or combinations of drugs in popular 
use are the many '' headache remedies," in pow- 
der or tablet, so largely advertised and found in 
every drug store, their principal constituent be- 
ing one of the coal-tar derivatives, usually acet- 
anilide, having a most depressing effect on the 
heart action. This class of remedies are often 
taken with prompt relief and without apparent 
harm, but a repetition of their use has, doubtless, 
been a factor in the production of many weak 
hearts, which are becoming too common, and thus, 
indirectly, the cause of many sudden deaths. 

Headache is but a symptom of some functional 
disturbance and requires a proper diagnosis and 
rational treatment, rather than powerful drugs, 
for the relief of pain. 



THE USE OF ALCOHOL. 

THE word alcohol, as used in this article, im- 
plies any alcoholic liquor or beverage. 
Like other poisonous or narcotic drugs, it 
has a legitimate use in medicine, and always will 
have by physicians who are not deterred from its 
use, or who are not biased by the harm they know 
to be done by its unnecessary use as a beverage. 
Only its legitimate and, so-called, moderate use is 
here considered. 

The use of alcohol is necessary as a solvent of 
certain drugs, and as a means of preserving cer- 
tain drugs and medicines. Its property of evap- 
oration makes it useful as an external application, 
either alone or in combination with other reme- 
dies. Alcohol is useful in certain depressed con- 
ditions of vitality, and in certain disease condi- 
tions, or in convalescence needing stimulation. 

Alcohol in small or medicinal quantities in- 
creases temporarily the strength of the hearths 
action and general nerve force and thus assists 
in maintaining vitality and circulation, and there- 
fore aids, temporarily, in maintaining life, or in 
tiding the sick over critical periods. 



136 Practical Hygiene 

A considerable proportion of alcohol, when 
consumed in small quantities, undergoes combus- 
tion, and prevents the oxidation or waste of tissue. 
It thus supplies a moderate degree of energy, con- 
serves the body forces, and, to a limited extent, 
becomes a food. This explains why continuous 
but moderate users of alcohol often grow fat. 

Alcohol IS not, however, a desirable food, be- 
cause some of it cannot be oxidized, and it is this 
portion, if its use is long continued, that causes 
irritation and inflammation in the process of ex- 
cretion, and thus it either excites or predisposes 
to kidney, liver or other diseases. 

When a small quantity of dilute alcoholic stimu- 
lant is taken into the stomach with or after a 
meal, it excites the secretion of digestive fluids, 
and thus temporarily promotes digestion, but its 
continued use, even in small quantities, soon leads 
to congestion of the lining of the stomach, fol- 
lowed by catarrhal and chronic inflammation. 

Alcohol, by exciting or increasing the action of 
the heart, sends more blood to the surface, giving 
a feeling of warmth to the skin and relieving tem- 
porarily internal congestions and possible inflam- 
mation, which is liable to result after unusual ex- 
posure to cold. The taking of alcoholic stimulant, 
anticipating exposure to cold, sends more blood 
to the skin, or cooling area of the body, where it 



Practical Hygiene 137 

is easily chilled, and thus increases the dangers 
resulting from cold exposure. 

The foregoing represents a common but falla- 
cious use of alcoholic stimulants. 

Alcohol unquestionably lowers body tempera- 
ture. 

The use of alcohol by healthy people excites or 
stimulates the nervous system to a point above 
the normal plane; with the subsidence of the 
period of stimulation there comes a corresponding 
period of depression, which requires the lapse of 
time, or more alcohol, for its restoration to the 
normal point. 

The consumption of alcohol by healthy people 
lessens their capacity for physical or mental work. 
It has been demonstrated that soldiers supplied 
with alcoholic liquors are less capable of long 
marches, and suffer more from fatigue. 

Alcohol is a disinfectant, yet its continued use 
predisposes the human subject to bacterial infec- 
tion. 

Dr. Emory McClintick, Actuary of the Mutual 
Benefit Life Insurance Company, of New York, 
in giving the mortality experience of his society 
during a long period of years on the lives of total 
abstainers and moderate drinkers, reported to the 
Actuarial Society of America ^ ' that the actual 
death rate compared with the expected death rate 
among moderate drinkers was twenty-three per 



138 Practical Hygiene 

cent, higher than among total abstainers.'^ 

The medicinal use of alcohol has materially and 
legitimately diminished in recent years ; the falla- 
ciousness of many of its former uses have been 
observed, and its harmful effects better under- 
stood. 

Alcohol, like some other drugs, has what is 
known as a cumulative action. When taken con- 
tinuously, even in small quantities, its residual 
effects accumulate and gradually affect functional 
activity, thus permanently injuring the efficiency 
and health of the individual. 

The immediate effects of alcohol are influenced 
by the age, habits or mode of life, and the per- 
sonal idiosyncrasies of individuals. 

The popular idea that alcohol is of especial ben- 
efit in old age is erroneous. The depression fol- 
lowing its use as a stimulant results in lowered 
vitality and the promotion of senility. 

People of sedentary habits succumb more rap- 
idly to the action of alcohol than do those who are 
active. Some people, especially those of sensi- 
tive or nervous temperaments, are profoundly 
affected by small quantities, while others can con- 
sume, habitually, large quantities for a long time, 
without apparent detriment, but when their vital- 
ity comes to be tested by labor, accident, or acute 
disease, it is sure to be found wanting. 

Alcohol has a property of creating a desire for 



Practical Hygiene 139 

more alcohol, and a continned daily use soon de- 
velops a physiological dependence from which it 
is hard to escape. 

It is the most productive, predisposing cause of 
disease. 

There are abundant statistics to show that 
habitual users of alcohol have the highest rate of 
mortality, and that five men engaged in the liquor 
traffic die of alcoholism, to one in all other occupa- 
tions. 

Diseases of the kidneys, heart and blood-vessels, 
and of the nervous system, are most frequent in 
habitual users of alcohol, and it also causes more 
than half of the cases of liver disease. 

The use of alcohol in perfect health can be pro- 
ductive only of harm. As a remedial agent it is 
useful only in small quantities and for short peri- 
ods. It is not useful as a medicinal agent except 
when it aids deficient functional or physiological 
processes. It should never be used unadvisedly. 



INTEMPEEANCE. 

THE ravages of the intemperate use of alco- 
holic beverages are manifest in every part 
of the world. 

Intemperance is the agent of depravity, degen- 
eracy and crime. It is the strongest factor in fill- 
ing penitentiaries, insane asylums, orphanages 
and institutions for degenerates, and the most 
prolific source of capital and petty crimes. 

It invades the home and destroys the happiness 
and sanctity of domestic life, into which it brings 
degradation, poverty, disunion, disease and pre- 
mature death. 

It is the agent of the libertine, in violating 
chastity, and in filling the brothels of all cities. 
By its use the passions are inflamed, self-control 
and judgment impaired, and multitudes of young 
men and women made slaves to debauchery and 
vice. 

It has a most demoralizing influence on society 
in general, and is doubtless its greatest curse. 

The burden of intemperance falls heaviest on 
the laboring man, to whom, more than to any 
other class of men, it is essential that he be sober 



Practical Hygiene 141 

and temperate, not only for Ms own sake, but for 
the welfare of Ms wife and cMldren. 

Intemperance in a community is detrimental to 
its industrial and commercial interests, and far- 
reacMng in its degrading influences on morality. 
Its suppression is a subject of great magnitude 
and importance, involving official honor and in- 
tegrity and individual good citizenship. 

There must be a correction of the ambiguity of 
laws governing the sale of liquors, a more definite 
fixation of responsibility for their enforcement, 
and the penalizing of some definite county, muMci- 
pal or local official for the laxity or failure of their 
enforcement. 

Under present laws in the State of New York, 
the power behind the liquor traffic is a gigantic 
factor in local politics, often having a deciding in- 
fluence in elections, and too often moulding or dic- 
tating the policy of elective officials. The influ- 
ence thus exercised is acknowledged by all good 
people to be most detrimental and demoralizing to 
the interests of good government and the general 
public welfare. 

State governments have long recognized the 
dangers in an unrestricted liquor traffic, and for 
the protection of the public have from time to 
time raised license fees, restricted open hours, and 
prohibited its sale on Sunday. 

The sale of liquor on Sunday, as tolerated in 



142 Practical Hygiene 

some cities in open violation of law, causes more 
harm than its sale on all the other six days of the 
week combined. Most men who patronize places 
where liquors are sold receive their week's pay 
on Saturday night. If drinking places are open 
on Sunday, much of the day will be spent in these 
resorts, and the money spent there by many men 
is needed by their families for the necessities of 
life. By closing the saloon on Sunday many men 
are deprived of temptation to drink, and may thus 
be saved the disgrace of intemperance, and will 
continue to be useful and honorable citizens, in- 
stead of a disgrace and reproach to themselves 
and their families. 

The saloon is a strong factor in the production 
of intemperance. It is, however, a legitimate in- 
stitution when it is law-abiding. Sometimes the 
saloon or its managers are not so much to blame 
for much harm that they do, and for not being 
law-abiding, as are municipal officials. 

Many men in the saloon business are naturally 
good fellows, and are willing to close their saloons 
on Sunday. In fact, it is only exceptionally that 
the saloonkeeper prefers to keep open on Sunday ; 
but if his neighbor is allowed to do so, he is losing 
trade by not doing so himself, and naturally fol- 
lows suit. 

Who is to blame for the wide open condition of 



Practical Hygiene 143 

many cities? Certainly the saloonkeeper is not 
directly so. 

A mayor is elected by the people. He appoints 
a commissioner of public safety, who in turn ap- 
points a chief of police. The mayor, of course, 
dictates or indicates, actively or passively, the 
policy to be pursued. If his chief object in office 
happens to be re-election, he at once begins to 
build fences to capture and retain the controlling 
vote. This he sees in the '' liquor element.'' 

The commissioner, the chief of police and the 
police force are all obligated to the mayor, and 
readily take the cue. They want to hold their 
jobs, and, as it doesn't pay to look for trouble, 
they fail to see the saloons that are open all night 
or on Sunday. So the town goes wide open, until 
the W. C. T. U., or the Ministerial Association, or 
some other ^^ meddlesome " folk, screw up their 
remittent indignation, and send forth their miser- 
able " spotters." 

The result is consternation in the police court ; 
" much needless " trouble for the district attor- 
ney; feigned protestations of astonishment on the 
part of all the officials except the police, who have 
nothing to say, and chagrin on the part of the gen- 
eral public. 

The mayor, the commissioner and the chief of 
police are always good men, strongly favoring 
the maintenance of excise laws (?), and, in their 



144 Practical Hygiene 

puerile innocence, are unable to see how thep are 
in any way responsible for the almost universal 
violation exposed by the society agents. It is thus 
plain that only the police are at fault, and surely 
they should not be blamed for what ^* they have 
not seen.'' 

After a general ^^ hot time,'' stirred up by the 
society agents, somebody gives the order to close 
up, and two or three dry Sundays are inflicted on 
the ** unfortunate town." In a short time the 
agents are out of business, and off the scent, and 
then there is a joyous return to Sunday opening. 

Who is to blame •? Is it the saloonkeepers, who, 
on complaint of society agents have been arrested, 
convicted, and paid their fines? No. It is some 
municipal official or officials, and whoever he is, 
or whoever they are, they deserve neither the 
vote nor respect of the public, and should be de- 
posed and punished for malefeasance in office. 



HOUSEHOLD HYGIENE. 

HOUSEHOLD hygiene implies a maintenance 
of healthful conditions in the home. The 
first essential, then, is a sanitary construc- 
tion of the house. To insure best conditions of 
soil and air underneath and about the isolated 
house, a considerable area about it should be 
drained with lines of porous tile, so laid as to 
divert all water that might tend to flow toward the 
house. It is also well to lay a line of tile under 
the foundation wall. 

The top of the footing course of the foundation 
wall should be on a line four inches below the 
final surface of the cellar floor, and should be cov- 
ered with a thick coat of asphalt, as should also 
the outer surfaces of the foundation wall to a 
level with the surface of the ground. The cellar 
bottom should be floored with three inches of con- 
crete; this smeared with a good coat of asphalt, 
and that in turn covered with four inches more of 
concrete. This method of construction will insure 
a dry cellar. 

Cisterns in the cellar should be discarded wher- 
ever it is possible to do without them. 



146 Practical Hygiene 

The first floor of the house should be at least 
two feet above the ground to insure good light 
and ventilation of the cellar. 

The arrangement and number of rooms in a 
house is largel}^ a matter of taste and economy. 
Ceilings should not be less than nine or ten feet 
high. 

A sleeping room for two people should, for con- 
venience and comfort, be not less than twelve feet 
square; the larger the better. Toilet rooms 
should always have outside windows. 

Polished hardwood floors are of much hygienic 
advantage. If rugs are used, they can be care- 
fully taken up and cleaned outside the house. The 
dust remaining on the polished floor can be wiped 
up without raising a dust in the room. 

Open fireplaces are not only cheerful things to 
have in the house, but furnish an excellent means 
of ventilation. The matter of ventilation must 
always be given careful consideration. 

The necessity for household hygiene is most 
seen in many of the poorer classes of tenements, 
about which general conditions are often very un- 
sanitary, and in which dilapidation or faulty con- 
struction render hygienic conditions almost im- 
possible. 

Proper hygienic conditions in tenements can be 
brought to a desired standard only by state and 



Practical Hygiene 147 

municipal laws demanding or regulating their 
proper construction. 

Hygiene must be practiced in house cleaning, 
or in sweeping and dusting. Use the broom as 
little as possible. The so-called carpet sweeper 
is better, as it picks up the dust without spreading 
it about the room. 

Dust from bare floors should be taken up with 
a damp cloth. 

Never use the feather duster; it only distrib- 
utes the dust about the house to be again depos- 
ited on furniture or other articles. Dust should 
be removed from furniture by wiping with a soft 
cloth, which the housemaid can frequently shake 
out of the open window. 

Household dust is largely street dust which is 
brought into the house in various ways, and is 
composed of all sorts of detritus and contains 
various kinds of bacteria. 

Furnace heated houses are usually more dusty 
than those heated by steam or hot water. Con- 
ductors or air boxes, carelessly built of wood in 
connection with many furnaces, permit the en- 
trance of much dust from the furnace room. 

The healthful condition of the house will be pro- 
moted by the use of electricity for lighting, in- 
stead of gas or oil. Many people have a perni- 
cious habit of sleeping with a light burning in the 
room. This practice is damaging to the eyes, and 



148 Practical Hygiene 

seriously vitiates the atmosphere of the room. If 
a lamp is used, and it be left turned low, the 
imperfect combustion thus caused results in still 
greater atmospheric impurity. 

It is quite a common practice to economize the 
use of coal by tipping or removing a lid from the 
kitchen range at night, and to turn the pipe 
damper horizontally, thus causing the escape into 
the room of large volumes of poisonous gas. 
Many serious and even fatal results have been 
caused in this way. 

Care should be exercised as to the source of ice 
used in the household, or refrigerator. It should 
be procured only of a responsible and reliable 
dealer. Ice from contaminated streams is unsafe 
to have about. If uncertain as to its purity, do 
not allow it in any way to come in contact with 
food or drink. 

Clear ice, free from crevices or bubbles, is most 
likely to be pure. Always discard as unsafe all 
snow ice, as it is porous and more capable of 
contamination from air or water. 

If your drinking water comes through lead pipe, 
and no water has been drawn for some time, allow 
it to run the length of the lead before drawing for 
use. Water absorbs lead, and lead is poisonous. 
Water stored in lead-lined tanks must not be used 
for drinking purposes. 

Never use faucet filters. They are nasty things. 



Practical Hygiene 149 

and only strain out gross impurities which should 
be seen. 

An important matter in the hygiene of the 
kitchen, and often overlooked, is the refrigerator. 

Milk and other foods are often spilled and will 
undergo decomposition, until the whole receptacle 
is charged with myriads of bacteria and disagree- 
able odors, which meats and other articles readily 
absorb and thus become contaminated and dan- 
gerous for food. 

Care must be taken to keep the refrigerator ab- 
solutely clean and that there be no spilling of food 
or leaky vessels used, or no dripping from the ice. 

Porcelain-lined refrigerators are the best, but 
all should be ventilated, or provide for constant 
air circulation, and be thoroughly cleaned once 
each week by a thorough washing with soap and 
water. 

In the interests of economy, as well as the 
health of the family, all foods should, as far as 
possible, be prepared in the home. 

Buy milk only in bottles, and don't keep it in 
open vessels in the refrigerator or about the 
kitchen. 

An occasional visit by the head of the family to 
the milk producer's farm will often aid in the pro- 
duction of a desirable product. 

Don't use canned fruits or vegetables when 
fresh ones are in season. 



150 Practical Hygiene 

Don't let your butcher sell you undrawn fowls. 
It is unsafe to use poultry or game that has lain 
long undressed, and drawn fowls at eighteen cents 
per pound are cheaper than the undressed at six- 
teen cents. 

On the hygiene of the kitchen much might be 
said, but scrupulous cleanliness will cover most 
requirements. 



HEATING AND VENTILATION. 

THE breathing of impure or vitiated air 
changes the character of the blood and re- 
sults in serious injury to health. 

Wherever people live or congregate, air is be- 
ing vitiated in the process of respiration by the 
removal of oxygen and the addition of carbonic 
acid and organic matter. Air is likewise rendered 
impure by combustion, by the burning of lamps, 
gas or other fires; so that if good health and 
physical efficiency is to be maintained, provision 
for a constant change of air is necessary in all 
buildings. This change must be accomplished by 
arrangements or appliances that will permit and 
insure a constant egress of foul air from all 
buildings, and all rooms in buildings, and at the 
same time a continuous ingress of pure air from 
outside. 

For economical reasons, provisions for the ven- 
tilation of buildings are usually combined with 
the system of heating. 

Modern heating is done by hot air, by steam 
and hot water. In heating by hot air furnaces, 
heat is supplied by a current of air taken from 



152 Practical Hygiene 

outside the building and passed through the air 
chamber of the furnace, where it is heated, and 
thence taken through flues to various rooms in the 
building. The warm air in the chamber and flues 
of the furnace being lighter than the cold air, it 
readily rises through flues provided for heating 
various portions of the building. The perfect 
heating of rooms is influenced by the readiness 
with which air may find exit from rooms. Thus, 
a flue for the exit of air should be provided for 
each room. This flue of exit should have a capac- 
ity slightly larger than that of the flue bringing 
in warm air and serves the double purpose of 
ventilation, or of carrying away vitiated air, and 
at the same time of favoring the entrance of warm 
fresh air from outside. This combined system of 
heating and ventilation provides for what is known 
as the gravity system of ventilation, and while it 
answers a fair purpose for small buildings or 
dwellings, it is not satisfactory for buildings or 
rooms where a large number of people congregate, 
because gravity ventilation cannot be depended 
upon to work well in mild weather, and may be un- 
favorably affected by other conditions in or about 
the building. And, again, furnace heated air has 
been impaired by excessive heat to which it is sub- 
jected in passing through the furnace chamber. 
The air of furnace heated houses is likely to be 
deficient in moisture, unless care is taken to pro- 



Practical Hygiene 153 

vide for its evaporation in the hot air chamber of 
the furnace, and, if necessary, in various rooms. 

Hot air furnaces are frequently installed so that 
the supply of air to the furnace is taken from 
some point vrithin the building, and when thus in- 
tailed, the air of such buildings is passed through 
the furnace again and again, which action, it is 
needless to say, is most unsanitary, as no new air 
is introduced and no vitiated air is allowed to pass 
out, even though flues be provided for its so doing. 
This arrangement permits the use of cheaper and 
smaller furnaces than would be necessary if cold 
air were taken exclusively from outside the build- 
ing. It economizes the use of fuel, but is detri- 
mental to health. 

Both steam and hot water may be used for 
direct and indirect heating. Direct heating by 
either steam or hot water is the radiation of heat 
from a radiator placed within the room. This 
method is economical for the production of heat, 
but provides for no ventilation or change or air. 
Indirect heating by steam or hot water is done by 
placing coils within a flue over which outside air 
is passed and thus heated before entering the 
room, when, if proper flues of exit are provided, 
gravity circulation and ventilation will be estab- 
lished. 

Wherever hot water or steam is used for heat- 
ing in combination with gravity ventilation, econ- 



154 Practical Hygiene 

omy will be conserved by a combination of direct 
and indirect heating. 

Hot water heating is more expensive to install 
than steam, but cheaper to operate, and supplies 
a heat that is more stable and agreeable. For in- 
direct heating in connection with gravity ventila- 
tion, steam is cheapest and most effective. 

Gravity ventilation should never be used in 
schools or other large buildings, as such buildings 
require as much or more ventilation in mild than 
in cold weather. For such buildings mechanical 
ventilation alone is reliable. 

This system is operated by fans moved by elec- 
tric, steam or water power, or by a gas engine. 
This method gives a positive supply of fresh air, 
insures ventilation, can be operated independent 
of heating, and is uninfluenced by atmospheric 
conditions. The air is blown over steam coils, and 
should be delivered to the room at the temperature 
desired in the room, if for ventilation only, or at 
a higher temperature if heat is required. The 
change of air should not be with such velocity as 
to cause drafts, as drafts lower the body tempera- 
ture and sometimes cause internal congestions 
and organic disturbances. 

Care should always be exercised to draw fresh 
air from outside, well above the ground, and free 
from dust or other contamination. It is always 



Practical Hygiene 155 

best to screen the fresh air flue at its external ex- 
tremity with a fine wire mesh. 

Fines for the exit of vitiated air should always 
extend through the roof of the building. 



INFECTIOUS DISEASES. 

THE term, Infectious Disease, is commonly 
used to cover all communicable diseases, 
or such diseases as may be transmitted 
from one person to another. When thus spread 
rapidly over large areas, they may be designated 
as epidemic. By infection is implied the introduc- 
tion of disease-producing organisms into the body. 
Infection may occur in various ways. The in- 
fecting organism may be introduced by direct in- 
jury, or by inoculation of a wound or cut, or by a 
sliver. The sliver, or other object producing the 
wound, may have on it the bacillus of pus, or 
diphtheria, or the germ of tetanus, or the wound 
may be infected subsequent to the injury. 

Infection may occur by means of the intestinal 
canal, through the food we eat, or the water we 
drink. Typhoid fever may be obtained in this 
way. The various intestinal worms are intro- 
duced by eating infected food. 

Infection may occur through the medium of the 
air passages, by breathing air contaminated by 
various disease- producing organisms. The bacilli 
of tuberculosis are, doubtless, often introduced 



Practical Hygiene 157 

through the air passages in this way, though they 
may be in food we eat, or be introduced through 
a wound. 

There are diseases that may be disseminated by 
the bites of certain insects. The insects carry the 
disease germs from one person to another, and 
thus excite the disease by inoculation. 

Flies may contaminate the food we eat with the 
various disease-producing organisms carried on 
their feet or bodies. 

In all communicable diseases, we must remem- 
ber that the true and only cause is a real live and 
active micro-organism, capable of reproducing 
itself when planted in favorable soil, and thus ex- 
citing a specific disease condition peculiar to itself. 

A real infection always requires a certain sus- 
ceptibility of the individual. In other words, 
many individuals have an inherent quality of be- 
ing able to withstand infection, or the presence of 
disease-producing germs, to which others will 
succumb. 

Several of the infectious diseases destroy this 
susceptibility of the individual, or render him im- 
mune to successive attacks, as in the case of small- 
pox, measles and scarlet fever. Others have no 
such peculiarity and may repeatedly attack the 
same person, as in the case of diphtheria or ty- 
phoid fever. 

Infectious disease germs may exist and be har- 



158 Practical Hygiene 

bored, cultivated, or reproduced outside the living 
body. While unsanitary conditions or environ- 
ment do not originate infectious disease germs, it 
is a fact well established that they are fostered 
and kept alive by filthy conditions, and their in- 
fectivity thus maintained and perpetuated in 
many instances for months, or even years. 

It frequently happens that isolated cases of in- 
fectious diseases develop and most careful 
and exhaustive study and investigation will 
fail to locate the source of infection, and this fact 
is not so singular, owing to the multitudinous 
ways in which infectious germs may be carried or 
transmitted from one to another, by the promis- 
cuous mingling of society in the affairs of life. 
But we must recognize at once and for all time 
that one case of infectious disease comes from an- 
other, and is due, invariably, to the failure of 
some one or more persons in authority to exercise 
proper care in simple cleanliness, isolation or dis- 
infection. 

Children are more susceptible to all infectious 
diseases than adults, owing, doubtless, to their in- 
ferior vitality and lesser resistance to disease- 
producing germs. Likewise are people not in vig- 
orous health, or those of lowered vitality from 
overwork, unfavorable environment or pre-exist- 
ing disease. 

The more important infectious diseases, and 



Practical Hygiene 159 

those about which we are most concerned, are 

tuberculosis, typhoid fever, diphtheria and scarlet 
fever. 

It is altogether unnecessary, in these days of 
progress and general intelligence, that many hun- 
dreds of homes should daily be made desolate by 
infectious diseases. Infectious diseases are intro- 
duced into the home by the carelessness of some- 
body. It may be by the milkman, who has had 
diphtheria, typhoid or scarlet fever in his family, 
and has himself infected the milk by his hands; 
or perhaps he has failed to wash properly or ster- 
ilize a bottle taken from some infected household, 
or he has washed his utensils with water from an 
infected well. It may be that the children have 
been playing in the street or at home with others 
so slightly ill that their diseased condition has 
been unrecognized, or in a household where dis- 
ease has existed a long time previous, or perhaps 
handled some toy infected months before. Some 
careless mother may have permitted her children 
to go to school or church while suffering from a 
sore throat or slight fever, and thus exposed hun- 
dreds of others to diphtheria or scarlet fever ; or, 
as frequently happens in a large city, families of 
children are ill with diphtheria or scarlet fever, 
and if the disease is of a mild type, they may pass 
through the course of disease and get well with- 
out the attendance of a physician, and perhaps 



160 Practical Hygiene 

return to school or mingle with other children too 
soon and without disinfection or change of cloth- 
ing, and thus spread the disease. Such children, 
families and homes remain prolific sources of in- 
fection for months, and perhaps years, after. 

I have seen parents who seemed to think that 
they had done a smart thing by concealing the fact 
that their children had an infectious disease. 
Such people have utter disregard for the safety 
or exposure of others; are selfish, inhuman and 
dangerous members of society. Others still exist 
who believe that their children must have all the 
infectious diseases sometime, and so, the sooner 
the better. Many have a superstitious dread of 
quarantine, or placarding by the health depart- 
ment, and for this reason conceal the existence of 
infectious diseases, or postpone calling a physi- 
cian as long as possible. Some even try to bribe 
the doctor not to report the case to the health de- 
partment. Physicians, too, have sometimes been 
careless in reporting cases and in giving proper 
instructions to infected families, for the protec- 
tion of themselves and others. 

In the school, infectious diseases are intro- 
duced and spread as may be in the family or home. 
Some child, slightly ill, is permitted to go to 
school ; or is, perhaps, taken ill in school or may 
have been sent to school too soon after recovery, 
and thus the seed is sown for a large and lasting 



Practical Hygiene 161 

epidemic. Books, pencils and papers, handled by 
infected children in schools, may become prolific 
media for the spread of infection; while children 
or teachers coming from infected homes may 
bring disease germs to the school in their clothing. 

Children suffering from indigestion or nausea 
should always be excluded from school, as should 
all those suffering the slightest fever or sore 
throat. Nausea, sore throat and fever may be the 
beginning of either scarlet fever or diphtheria, 
and children suffering from such symptoms must 
not be tolerated in school. Children exposed to 
the infection of diphtheria, scarlet fever or 
measles should be excluded from school during 
the period of incubation. The period of incuba- 
tion is that period which elapses between actual 
infection and the appearance of the first symp- 
toms of the disease. This period varies consider- 
ably as regards the different diseases, and ranges 
from a few days to two or more weeks. In ty- 
phoid fever, it is from two to six weeks ; in diph- 
theria, from one to seven days; in scarlet fever, 
five to eight days ; in measles, it is from eight to 
fourteen days. 

The most important point for consideration, in 
connection with infectious diseases, is their pre- 
vention. The statement has been made that 
^ ^ sickness is ignorance ' ' and, so far as infectious 
disease is concerned, this statement is more than 



162 Practical Hygiene 

half true ; for if it were not for the ignorance or 
carelessness of people, with reference to the 
proper care of those sick with infectious diseases, 
and their environment with reference to the pro- 
tection of others, diphtheria, scarlet fever, 
measles, whooping cough, typhoid fever and con- 
sumption, as well as other maladies, might be en- 
tirely eradicated from civilized communities. 

In the prevention of infectious diseases the gen- 
eral health of individuals, their natural vitality 
and resisting qualities, all of which are largely in- 
fluenced by environment, mode of living, etc., must 
be given due consideration. Many healthy indi- 
viduals, doubtless, have within themselves certain 
qualities enabling them to resist disease-produc- 
ing organisms. The nearer approach to perfect 
health, the better and more complete is this re- 
sistance. 

Infectious diseases do not result, directly, from 
unsanitary environment, or from dirt or filth of 
person or place; but unsanitary surroundings, 
bad-smelling and illy ventilated habitations, 
schools, shops, etc., lack of sunlight and of per- 
sonal cleanliness and exercise, and improper food, 
excesses and intemperance, all have their depress- 
ing and devitalizing influence, especially upon 
children, and render them more susceptible to the 
attack of disease-producing organisms, and much 
less liable to withstand and recover an attack. 



Practical Hygiene 163 

One essential, then, in the prevention of infec- 
tions, or any other class of diseases, is good 
health and favorable conditions for maintaining 
good health. But this is not enough. Good 
health, though of much avail, is not a guarantee 
against infection in the presence of ignorance, 
carelessness or superstition. The progress of 
modern medicine has shown that the calamities of 
the past, resulting from infectious diseases, are 
unnecessary and avoidable, and '^ we no longer 
tolerate the helpless and fanatical attitude of 
fatalism. ' ' 

"We must remember that infectious diseases are 
preventable diseases, but are not and can not be 
prevented by a few intelligent laymen, nor the 
strenuous efforts of a few hygienic enthusiasts or 
sanitary officials, but only by the combined efforts 
of the general public, intelligently obeying ra- 
tional rules of quarantine and disinfection with a 
conscientious regard for the safety of others. 

TUBEROULOSIS. 

Of the infectious diseases mentioned, tubercu- 
losis is of the first importance. Tuberculosis, or 
the disease commonly known as consumption, 
causes more than one-seventh of all deaths the 
world over. One hundred and fifty thousand peo- 
ple die annually of this disease in the United 
States. In the last decade, one hundred and thirty 



164 Practical Hygiene 

thousand deaths have been caused by this disease 
in New York State alone. There is said to exist, 
constantly, in New York City, an average of about 
ten thousand cases, and all other cities have their 
respective quota, nearly, if not quite, as large in 
proportion to their size. It is found in all condi- 
tions of life, and is, without question, the greatest 
destroyer of human life. There is to-day no other 
problem, political, economic or hygienic, that ap- 
proaches in importance that of the prevention of 
tuberculous disease. 

The history of the disease dates back to the 
earliest writings on medicine ; yet it was not until 
1882 that its aetiology or causation was clearly 
understood and proven. The term tuberculosis 
signifies the formation of tubercles, or little lumps 
of cheesy material of varying sizes. These tuber- 
cles of cheese-like formation will, in the natural 
course of the disease, break down or suppurate, 
and if existing in the lungs the matter thus formed 
will find its way into the air cells or bronchial 
tubes, to be finally expectorated. The term con- 
sumption, used synonymously with pulmonary 
tuberculosis, is an unscientific word, and simply 
means a wasting disease. 

That tuberculosis is an infectious and prevent- 
able disease was clearly established by the Ger- 
man physician, Eobert Koch, in 1882, when he 
clearly and definitely demonstrated that its exist- 



Practical Hygiene 165 

ence was due solely to the presence of a living 
microscopic parasite or germ, which he terms and 
which has since been known as the tubercle 
bacillus. So small is this germ that a half million 
or more may be laid over the area of a five cent 
piece. Without this germ there can be no tuber- 
culous disease. 

Tuberculosis is a curable as well as preventable 
disease, but the public should, of course, be most 
interested in the matter of its prevention. The 
best results in its prevention cannot be obtained 
until the public has a clear appreciation of the 
nature of the disease and methods by which infec- 
tion is spread. 

Tuberculous disease may affect any of the vari- 
ous organs of the body, but that form of the dis- 
ease most common, and about which we are most 
concerned, is pulmonary tuberculosis, or tubercu- 
lous disease of the lungs, and it is this form of the 
disease which is most infectious and dangerous to 
others, because millions of the tubercle bacilli may 
be expectorated daily by the tuberculous patient, 
any or every one of which is a danger to human 
life. 

The bacillus tuberculosis has the property of be- 
ing able to reproduce itself in countless numbers, 
causing tuberculous disease when implanted in 
favorable soil. Thus, if a living tubercle bacillus 
in any manner enters the air passages, the alimen- 



166 Practical Hygiene 

tary or intestinal tract of a living individual, 
tuberculosis is liable to ensue. The bacillus may 
find entrance to the lungs in the form of dust, or 
to the intestinal tract with food or drink, or it may 
enter by way of inoculation through a wound or 
abrasion of the skin. 

Tuberculous disease is not necessarily excited 
at the point of contact or entrance to the body. 
Thus, if the bacillus be taken into the intestinal 
tract, tuberculous disease of the intestines or con- 
tiguous structures may be excited and developed, 
or the infecting bacillus may pass through the cir- 
culation or lymphatics to the lungs, brain or other 
structures before beginning its work of destruc- 
tion. 

There is, doubtless, something in the blood or 
secretions of many healthy individuals, capable of 
destroying the tubercle bacillus, unless its num- 
bers be overwhelmingly large, or the disease 
would be still more prevalent than it is at present. 
Thus, it is generally conceded that the acid secre- 
tions of the stomach, in healthy adults, will de- 
stroy tubercle bacilli, as well as other disease 
germs. But in young children or adults suffering 
from indigestion, or in those of low vitality, the 
gastric secretion may be alkaline, and thus does 
not affect the vitality of the bacillus. 

This fact readily accounts for the excess of 
tuberculous disease in the intestines and append- 



Practical Hygiene 167 

ages of children and young people over that found 
in adults. 

As has been before stated, tuberculosis is a pre- 
ventable disease to all who are wise and careful 
enough to separate all infection of the tubercle 
bacillus from their food, habitations or environ- 
ment. How is this to be accomplished! The seg- 
regation or quarantining of all human beings or 
animals affected with tuberculosis is a rational 
and radical method of procedure, but the condi- 
tions of society, family relations and public opin- 
ion seem to render this method impossible. In 
fact, our knowledge of the disease, and experience 
in methods of its prevention, at the present time 
do not seem to warrant such radical measures, for 
the tuberculous patient may safely live and mingle 
with healthy people without special danger to 
them, provided he or she will carefully collect and 
destroy their sputa. It is the matter expectorated 
that contains the tubercle bacilli in great numbers, 
and if this is discharged anywhere in the home, in 
the street, or in any public place whatever, it be- 
comes a source of great danger to human beings 
or animals, by the possibility of its becoming dried 
and, in the form of dust, contaminating the air 
they breathe or the food they eat. 

The sputum of tuberculous patients must be 
carefully collected and destroyed. The patient 
should always expectorate in a cloth or piece of 



168 Practical Hygiene 

gauze, which should be immediately burned; or, 
better still, expectorate in a receptacle devised 
for the purpose, when it should be burned or dis- 
infected before it is deposited in the sewer or 
buried in the ground. Anything touching the 
tuberculous patient's mouth should be at once 
sterilized by boiling for a half hour. It is, doubt- 
less, possible for a tuberculous patient to contami- 
nate the atmosphere of a room by throwing out 
bacilli in the form of invisible spray when cough- 
ing, and it is, therefore, advisable that they should 
hold a handkerchief or piece of gauze over the 
mouth while coughing. 

The consumptive patient should always sleep 
alone, in a room by himself, and always with win- 
dows open. The room occupied by the patient 
should permit of good ventilation and admit a 
plentiful amount of sunlight, as sunlight and fresh 
air are great destroyers of tubercle bacilli, as well 
as other disease-producing germs. 

Among the possible sources of tuberculous dis- 
ease in human beings must be mentioned the use 
for food of milk or flesh of tuberculous animals. 
Cattle, swine and fowls, as well as other animals, 
are subject to tuberculous disease, which is prac- 
tically identical with that of the human. The milk 
of tuberculous cows is known to contain the 
tubercle bacillus, which, when fed to healthy ani- 
mals, has speedily and rapidly produced the dis- 



Practical Hygiene 169 

ease. Likewise, the flesh of tuberculous animals, 
fed to healthy animals, will readily produce the 
disease. Authentic cases of human tuberculosis 
through the use of milk of tuberculous cows are 
many, and are constantly being brought to our 
attention. Danger from this source can only be 
prevented by a regular and systematic state or 
municipal examination of dairy cattle and abat- 
toirs, and the destruction of all cattle and meat 
found diseased. 

Notwithstanding that infection is the principal 
and only direct cause of tuberculosis, environment 
and heredity must not be lost sight of as predis- 
posing causes. Environed by unfavorable sani- 
tary conditions, the vitality of a previously strong 
man may be so impaired as to make him an easy 
prey to the attack of the tubercle bacillus, as well 
as to other disease-producing germs. People liv- 
ing in or working in dark, damp and badly venti- 
lated places or dwellings, readily succumb to the 
inroads of the bacillus, as do also those who fail 
properly to care for their bodies by proper bath- 
ing, exercise, etc. 

While the disease is not considered hereditary, 
or actually transmitted from parent to offspring, 
parental susceptibility and constitutional peculi- 
arities or tendencies as to vigor, vitality, resist- 
ance, weakness, etc., are inherited. It is not prob- 
able that tuberculosis is ever inherited unless the 



170 Practical Hygiene 

parent has actual tuberculous disease of the gen- 
erative organs, which is extremely rare. 

It is believed possible for the tuberculous 
mother to have a healthy child, and free from 
tuberculous disease ; but it is not likely that such 
a child would long remain free from this disease 
if the mother were allowed to nurse or even care 
for it in any way. 

The establishing of municipal hospitals for the 
care of indigent consumptives will do much for the 
prevention of the spread of tuberculous infection. 
The general hospitals should not receive these 
people. 

Aside from the danger of spreading tubercu- 
lous infection in the general hospitals, the needs 
of consumptive patients require such different 
conditions and methods of treatment as to render 
their treatment in the same institution very objec- 
tionable. In the general hospital there is neither 
hope nor possibility of recovery for the consump- 
tive, but there is certainty of his jeopardizing the 
lives of others. 

For the well-to-do consumptive the city hospital 
is not a necessity. He can, if willing and intelli- 
gent, receive proper care in his own home or in 
a private sanitarium in the climate most suited 
to his case. But not so with the poor, to whom 
climatic advantages are often denied, and who are 
obliged to live in quarters always too small and 



Practical Hygiene 171 

poorly ventilated, and, usually, without pretense 
to sanitary arrangements. 

Consumption is no longer an incurable disease. 
Very many cases, recognized early, under favor- 
able conditions of environment and proper hy- 
gienic, dietetic and medical treatment, recover. 
While climatic treatment is always much to be de- 
sired, even this is no longer necessary for the re- 
covery of a large percentage of incipient cases. 

TYPHOID FEVER. 

Typhoid fever is an important and exceedingly 
dangerous infectious disease. It is essentially a 
disease of the intestines, and is caused by a spe- 
cific germ known as the bacillus typhosus. This 
disease prevails principally in temperate climates 
throughout the world, and, in this country, occurs 
most frequently in the autumn months. It is seen 
most often in youth or early adult life. Defective 
drainage and contaminated water supplies are the 
two principal factors favoring the distribution 
and growth of the bacillus. Filthy, overcrowded 
and unsanitary conditions generally, are acces- 
sory factors of causation, only in lowering the re- 
sistance of the individuals exposed. Outside the 
body the infective germ retains its vitality in 
water for a long and indefinite time. The germ 
may be conveyed to healthy individuals in various 
ways. Infected water is, doubtless, the most fre- 



172 Practical Hygiene 

quent method of conveyance. It may also be 
transmitted from one person to another through 
the air. 

The infective germ in typhoid exists principally 
in the excreta of the infected individual, and if 
they could be destroyed or disinfected in all cases, 
typhoid would soon be known only in history. 
Unfortunately, this has not been done and, doubt- 
less will not be done in many instances for a long 
time to come, though it is not a difficult matter, 
with reasonable care and attention, with the aid 
of known methods of disinfection. 

If the excreta of the typhoid patient are not 
properly disinfected before entering the sewer or 
privy vault, the germs may find their way to 
wells, streams, water courses or other bodies of 
water, and thus, through streams, natural water 
courses, subterranean or on the surface, water 
very remote from the source of infection may be 
contaminated. Through the medium of contami- 
nated water, foods may be infected and their in- 
gestion excite the disease. The milk supply may 
be contaminated by washing cans or other utensils 
in infected water. Eating fresh vegetables, as 
lettuce or celery, washed in polluted water, may 
cause the disease. Washing the hands and face in 
typhoid polluted water is a dangerous proceeding. 

In the army camps of the Spanish-American 
War, the number of cases of typhoid fever in the 



Practical Hygiene 173 

various camps varied directly with the methods of 
disposing of the excreta. The spread of typhoid 
in the camps in 1898 was shown to be largely due 
to common flies, which contaminated their bodies 
with the excreta of the typhoid patients, deposited 
in open trenches, and thus carried the disease 
germs to the food of the soldiers. 

As before stated, the typhoid germ is found 
principally in the excreta of those suffering from 
the disease, and to prevent typhoid fever, the ex- 
creta of typhoid patients must be thoroughly dis- 
infected before they are deposited in vaults or 
sewers, or even buried in the ground. In the man- 
agement of typhoid cases, scrupulous care must 
be taken to disinfect and cleanse all spoons, 
dishes, utensils or linen used by or about the pa- 
tient. It is possible for the typhoid bacillus to 
dry and mingle with particles of dust, and thus 
contaminate the atmosphere, food or drink. 
Numerous observations have demonstrated that 
the typhoid germ can retain its vitality in dry 
dust for a variable length of time. It has been 
shown that it may live as long as sixty days in dry 
soil, and, in moist soil or water, it may live and 
propagate for years. 

DIPHTHERIA. 

Diphtheria is a specific disease, characterized 
usually by an exudate membrane in the throat. 



174 Practical Hygiene 

larynx or nose, and accompanied by varying 
symptoms of fever, prostration, etc. 

The disease is caused by a specific germ called 
the Klebs-Loefifler bacillus. The disease has been 
known since the earliest writings in medicine. It 
is a highly contagious, infectious and dangerous 
disease, and is readily communicated from one 
person to another. The bacilli may be received 
and the disease induced from the membranous ex- 
udate, or discharges, from the diphtheretic pa- 
tient, or from the secretions of the nose and throat 
of a sick or convalescent patient, in which virulent 
bacilli exist. The disease may also be transmitted 
by inoculation. 

As in other infectious diseases, individual sus- 
ceptibility plays an important role. Not only do 
very many of those exposed escape, but even many 
of those in whose throats the bacilli lodge and 
grow, fail to develop the disease. An attack of 
the disease renders the subject immune to a sec- 
ond attack for only a short time. 

While it occurs most frequently in early life, 
no age is exempt from an attack, and while the 
disease is only caused by the specific bacillus from 
some preceding case, unsanitary environment, 
catarrhal trouble, or pre-existing disease, by low- 
ering vitality and resistance, predispose the indi- 
vidual to the attacking germ and render him a 
more easy prey. 



Practical Hygiene 175 

The prevention of diphtheria lies only in the 
most careful attention to cleanliness in the care of 
the diphtheria patient, the absolute destruction or 
disinfection of all discharges from the mouth, 
throat and nose, and the disinfection of all linen 
or clothing soiled by the patient. The linen, 
spoons or dishes used by or soiled by the patient, 
or used about the room, must be placed in a vessel 
by themselves and boiled for at least twenty 
minutes. 

The infecting bacillus in diphtheria is in the 
discharges from the throat and nose, and may, 
doubtless, be communicated through the breath of 
the patient. A patient suffering from diphtheria 
must be kept closely quarantined until a bacteri- 
ological examination shows the throat free from 
the infecting bacillus. 

Since the discovery of anti-toxine, diphtheria 
has been robbed of much of its peril and terror, 
and at the present time death from diphtheria is 
exceedingly rare, if enough anti-toxine is adminis- 
tered early in the disease. It is very important, 
however, that there be no neglect or delay in the 
early recognition of the disease, or, in other 
words, that a bacteriological examination be made 
at the earliest possible time after the appearance 
of an exudate in the throat or symptoms of croup, 
so that anti-toxine may be administered at the 
earliest possible time. In fact there should be no 



176 Practical Hygiene 

delay in the use of anti-toxine if diphtheria is sus- 
pected. It will do no harm if the case is not diph- 
theria, and its early use is most important in the 
true disease. 

SCAELET FEVEE. 

Scarlet fever is a very dangerous infectious dis- 
ease, characterized by fever, sore throat and a 
diffuse exanthem or eruption of scarlet color and 
variable intensity, lasting a week or ten days, 
more or less, and usually followed by a desquama- 
tion of outer skin, lasting from three to six weeks 
longer. 

The disease is usually ushered in by vomiting, 
followed in a few hours by sore throat, fever and 
the eruption. Scarlet fever is a widespread dis- 
ease, appearing in nearly all parts of the world, 
and attacks all races. It seems to occur sporadic- 
ally, from time to time, in epidemics, varying in 
severity. Doubtless, owing to poorer ventilation 
of habitations and closer confinement of people, 
the disease seems to occur with greater intensity 
in autumn and winter, but it exists at all seasons. 
Although it occurs most frequently in children, no 
age seems to be exempt. Unlike diphtheria, one 
attack usually renders the subject immune to fur- 
ther infection. Subjects of this disease are prone 
to certain sequelae affecting the kidneys or heart, 
or causing trouble with the middle ear, and deaf- 



Practical Hygiene 111 

ness. The specific germ causing the disease is still 
unknown. 

The contagion of scarlet fever develops early 
in the disease and continues during the period of 
desquamation. It is, doubtless, in the breath and 
excretions of the patient, as well as in the scaly 
particles thrown off from the skin. The poison 
clings with great persistence to clothing, articles 
of furniture and other things in the sick room. 
Bedding, clothing, playthings and books used by 
or about the patient and put away for months, or 
even years, unless thoroughly disinfected, harbor 
and convey contagion. Nurses and others in con- 
tact with the sick may carry the poison to persons 
at a considerable distance. 

Prevention of scarlet fever lies only in the per- 
fect isolation of the sick, from the beginning of 
the disease to the completion of the period of 
desquamation, and the fullest and most complete 
disinfecting and cleansing not only of the room, 
but the entire house, the bed, bedding, clothing 
and everything in the sick room, or that has come 
in contact with or been near the sick. 

MEASLES AliTD WH00PI:N'G COUGH. 

Measles and whooping cough are by no means 
harmless ailments, and indirectly cause many 
deaths or disabilities by reason of complications 
that are very liable to supervene. Though most 
children have these diseases at some time, it is en- 



178 Practical Hygiene 

tirely unnecessary that they should, and children 
or adults should never be needlessly exposed to 
their infection. While the infective element in 
these diseases is short lived, it is very active dur- 
ing their entire course, and may, doubtless, be 
carried from place to place in the clothing of well 
members of infected families. 



DISINFECTION. 

FOE the prevention of the spread of infectious 
diseases, the disinfection of infected dwell- 
ings or apartments is of no less importance 
than the maintenance of a proper quarantine dur- 
ing the prevalence of infectious disease. Infected 
premises and their contents should be disinfected 
immediately after the death or recovery of the 
patient, as disease-producing germs thrown off 
by the sick are very tenacious of life, and cling 
with persistence to the ceiling, walls, furniture, 
bedding, clothing and in fact everything in or 
about the room or apartment occupied by the sick. 
Restriction of disease germs, even under most 
favorable conditions, to the room occupied by the 
person sick, is so uncertain that the entire house 
or apartment occupied by the family should al- 
ways be disinfected, giving special attention of 
course to the sick room. 

In some cities and towns having a well organ- 
ized health department, disinfection will be prop- 
erly done by such officials, but it will not always 
be safe to depend on disinfection done by officials 
appointed, because of political, rather than for 



180 Practical Hygiene 

practical qualifications and fitness for this work. 
Thus it becomes necessary that heads of families 
should understand and often take into their own 
hands the matter of disinfection. 

The final cleansing and disinfection of the sick 
room and its contents is simplified by the removal 
from the room of carpets, rugs, draperies and all 
other articles not absolutely necessary for the 
care and comfort of the patient, as soon as pos- 
sible after the infectious nature of the illness is 
suspected. After the recovery of a patient and 
when it is thought to be safe for him to leave the 
room or go out, a complete suit of clothing should 
be placed in the bath room, and the room and con- 
tents fumigated. After the room has been aired 
out, the patient should take a full bath, put on the 
disinfected clothing, then wrap a clean and disin- 
fected sheet about him and either leave the house 
or go to some other disinfected room, when the 
remainder of the house is then ready for its final 
cleansing and disinfection. Before disturbing or 
removing anything from the infected room, it, 
with the entire house or apartment occupied by 
the family, should be disinfected, after which 
worthless articles in the infected room may be re- 
moved and burned, and a tub containing a solution 
of bichloride of mercury, one to one thousand, 
should be brought into the room, and all washable 
articles of clothing immersed therein for a few 



Practical Hygiene 181 

hours, and then wrung out, boiled and washed. 

The floor, ceiling, wood-work and furniture 
should then be rubbed with a damp cloth, satur- 
ated with the solution of bichloride of mercury, 
after which the room should be left unocuupied 
for a week, with windows open and all possible 
sunlight admitted, after which it will be perfectly 
safe to occupy. 

A thorough general house-cleaning is always 
advisable after disinfection is over. Carpets, 
rugs or upholstered furniture should be beaten 
and exposed several hours in the sun. Safety 
against the spread of disease requires that dis- 
infection must always commence with the begin- 
ning of the case and continue during the en- 
tire course of the illness. Liquid disinfectants 
must be constantly on hand, and in use in the sick 
room for the disinfection of excreta, and utensils 
or linen soiled by the patient. Nothing must leave 
the sick room until after disinfection. 

For liquid disinfection, one drachm (60 grains) 
of bichloride dissolved in one gallon of water, an- 
swers the best purpose. Soiled linen should be 
immersed in this solution for four hours, and then 
boiled. Discharges from the patient should be 
received in a vessel containing this solution, or a 
solution of chloride of lime, six ounces to one gal- 
lon of water. 

It is good practice to keep a sheet hung over 



182 Practical Hygiene 

the door of entrance or exit from the sick room, 
and occasionally spray the sheet with the bi- 
chloride solution. 

To attempt to disinfect the air of a room occu- 
pied by the sick, by any gas or vapor, is both use- 
less and dangerous to the patient, but much good 
is accomplished by the admission of an abimdance 
of fresh air and sunlight. 

Notwithstanding the infection from the patient 
may have been closely confined to one room, it is 
well to bear in mind that there are various ave- 
nues for the dissemination of infectious germs 
about the house, hence the advisability of disin- 
fecting the entire house, and when a home is oc- 
cupied by several people it is often necessary to 
do a portion at a time. 

The general or areal disinfection of houses or 
apartments can be effectively accomplished only 
by the liberation of germicidal gases, which im- 
pregnate the air and penetrate fabrics and inac- 
cessible places. 

The gases of most practical value as disinfect- 
ants are sulphur dioxide, generated by the burn- 
ing of sulphur, and formaldehyde, a gaseous pro- 
duct of the oxidization of wood alcohol, and usu- 
ally used for disinfecting purposes in a forty per 
cent, solution. 

Effective application of either of these agents 
always requires certain preliminary precautions 



Practical Hygiene 183 

or preparation. First, that the gas may be closely 
confined, close all doors and windows, except the 
door of exit, then close all cracks in doors and 
windows by pasting paper over them. Second, 
close all other openings, such as ventilators, reg- 
isters or fireplaces. Third, that the gas may have 
easy access to everything about the room, open 
all closets, drawers and trunks, and see that all 
clothing, blankets or bedding are spread over 
chairs or hung on lines stretched across the room. 

DISINFECTION BY SULPHUE. 

The gas from burning sulphur is a reliable dis- 
infectant, if sufficient sulphur is used and an ex- 
posure of ten hours is given. 

There are objections, however, to its use. It 
has a deleterious action on certain fabrics, and 
tarnishes copper, brass, silver or gold. In places 
where no harm will result from its use, it is the 
cheapest disinfectant and most simple of applica- 
tion. Four pounds of powdered sulphur should 
be used for every one thousand cubic feet or for 
a room ten by ten, by ten feet high; a sufficient 
amount of sulphur for the space to be fumigated 
should be placed in an iron pot, and the pot placed 
on two or three bricks in a tub of hot water ; pour 
a little alcohol over the sulphur, ignite it and leave 
the room or house closed for at least ten hours. 

The presence of moisture favors the germicidal 



184 Practical Hygiene 

action of sulphur, thus placing the kettle of sul- 
phur in a tub of water serves the double purpose 
of securing moisture in the room and protection 
from the danger of fire. If an apartment or entire 
house is to be fumigated, it is best to ignite several 
kettles of sulphur simultaneously in the various 
rooms to insure a rapid diffusion of gas through- 
out all rooms. 

DISINFECTION BY FORMALDEHYDE. 

For this purpose the forty per cent, aqueous 
solution should always be used. There are in the 
market various forms of so-called solid formalde- 
hyde or candles, which are very convenient, but 
most of them are less reliable and more expensive 
than the solution. 

To disinfect with the formaldehyde solution it 
is necessary to evaporate a sufficient quantity in 
the space to be treated and to take the same pre- 
liminary precautions as mentioned for sulphur 
fumigation. 

The solution may be evaporated by one of sev- 
eral apparatuses designed for the purpose, by 
boiling it in a kettle or by spraying or sprinkling- 
it on sheets hung over a line stretched across the 
room. The last mentioned method is effective 
and easiest of application for household use. 

Formaldehyde gas has no deleterious action on 
household effects. It will, however, destroy 



Practical Hygiene 185 

plants. The solution should not be allowed to 
touch the hands or be spilled upon the floor, car- 
pets or furniture, or anything that cannot be 
washed, and care must be taken in sprinkling the 
sheets not to allow the solution to drip from them. 

Eight ounces of the forty per cent, solution 
should be used and sprinkled on two sheets for 
each 1,000 cubic feet. The sheets must be sprayed 
with the solution after they have been stretched 
upon lines. 

The operator will find it to his advantage to 
work rapidly after he begins to spray the sheets 
and to leave the room promptly after the opera- 
tion is over, as the gas is very pungent and irritat- 
ing to the eyes and air passages. 

After ten hours of exposure the room or house 
should be opened or aired thoroughly and the 
sheets immediately placed in a tub of cold water. 
If the odor of formaldehyde persists in the room 
to a disagreeable degree after a thorough airing, it 
can be neutralized by sprinkling ammonia on a 
sheet and hanging it in the room for an hour or so. 



SCHOOL HYGIENE. 

THE subject of school hygiene should embrace 
not only the sanitary location and con- 
struction of school buildings, and the 
health and comfort of the children, but the physi- 
cal, educational and moral fitness of teachers for 
their work. 

The possession of knowledge, gained at the ex- 
pense of health and deficient physical and moral 
training, is an acquisition of little value. 

Physical comfort and sound health of school 
children are all-controlling elements, not only in 
the acquisition of knowledge, but in its practical 
application and usefulness, as well as in the moral 
development of the individual. 

The school building should be located, if pos- 
sible, on high and dry ground, and far enough 
from other buildings to insure the admission of 
good light, and as far as possible from the street 
in order to avoid noise and dust. While trees are 
always desirable, they should not be near enough 
to overshadow the building or exclude light. It 
should have a basement under all, with windows 
high enough above ground to admit of sunlight. 



P r a ctic al Hygiene 187 

All underground walls should be rendered im- 
pervious to water by covering their exterior with 
asphalt; also, tarred paper covered with asphalt 
should be laid over the footing course of all walls. 
The basement should be at least ten feet high. 
The floor of the basement should be of cement, 
covered with asphalt. Wood floors are short- 
lived in basements without a good circulation of 
air underneath, and cement floors are objection- 
able because they will wear off and are always 
dusty. As a rule, school buildings should be only 
two stories above the basement, as climbing stairs 
causes strain which is injurious to some children. 

The main corridors or halls of school buildings 
should always be from ten to twelve feet wide. 
There should always be at least two stairways, not 
less than six feet wide. Corridors, stairways and 
cloak rooms should always be well lighted and 
ventilated. 

All outside doors should open outward, and 
provision should always be made for a separate 
entrance for boys and girls. 

In finishing the interior, the woodwork should 
be as smooth as possible, and free from crevices 
or ledges where dust may collect. 

The size of the building or the number of its 
rooms must depend, of course, on the number of 
children to be accommodated. 

When given the number of rooms and the num- 



188 Practical Hygiene 

ber of children each room is expected to accom- 
modate, the architect must so group and arrange 
the rooms with reference to each other and neces- 
sary halls and entrances as to give best results in 
convenience for entrance and exit, and provide for 
best possible light as well as economy and effi- 
ciency in heating and ventilation. 

Careful experiments have determined that the 
air space required per pupil is at least 240 cubic 
feet, and experience has demonstrated that the 
number of pupils to whom one teacher can give 
proper attention should be limited to forty, and 
thus a standard for size has been practically fixed 
for school rooms. 

Oblong rooms seem to give the best service for 
convenience and light. A room twenty-five feet 
wide by thirty feet long and thirteen feet high 
will give forty pupils eighteen and three-fourths 
square feet of floor space and 243% cubic feet of 
air space, and will answer all necessary require- 
ments if well lighted and proper ventilation is 
provided for and maintained. For reasons well 
known to all primary teachers primary rooms 
should not be smaller than those for older pupils. 

Primary pupils, for best results in school work, 
need frequent diversion for the relief of fatigue 
and restraint caused by sitting still and for exer- 
cise for muscular development necessary for men- 
tal activity. 



Practical Hygiene 189 

School rooms are never too well lighted. The 
amount of glass surface admitting light should 
be at least one-sixth the floor space of the room. 
It is better to have light enter the room at the left 
and the rear of the pupils. 

Window shades are necessary to exclude the 
dazzling light of sunny days or when the ground 
is covered with snow. Shades should be opaque, 
and their color should correspond as nearly as 
possible with the color of the walls of the room. 
Double shades should be hung in the center of the 
window so that either section may be raised or 
lowered as necessity demands. The ceiling of the 
room should be painted white and the side walls 
light gray, pale yellow or light green. Light col- 
ors are easy and restful to the eye, and absorb less 
light than dark. The paint should be without 
gloss and stippled to avoid the effects of reflection. 

Desks and seats should be as near as possible 
to the light, and the widest aisle near the black- 
board, thus giving space for work and exercise 
where it is most needed. The blackboard should 
be of slate, as it can be washed without injury 
and lessens the nuisance from dust. 

Blackboards should be in height according to 
the needs of the different grades; for primary 
grades the bottom should be about two feet from 
the floor. 

School desks and seats have unquestionably 



190 Practical Hygiene 

been the cause of much discomfort, and the ex- 
citing cause of serious physical defects in chil- 
dren, as well as the origin of discussion and 
dissension between school authorities and sani- 
tarians. Improper seats or desks result in faulty 
postures, which are factors in causing defective 
sight and physical deformities. Inasmuch as a 
large part of the most active period of growth of 
children is spent in school, careful attention 
should be given the subject. Desks and seats must 
provide for vertical adjustment in order to pro- 
vide for variation in height as well as variations 
in growth of pupils of the same age. The top of 
the desk should slant at an angle of fifteen de- 
grees. An adjustable slant is also frequently de- 
sirable. Its rear edge should be on a vertical line 
with the front edge of the chair. To meet the 
needs of some children, or to keep them from 
bending forward too much, it may be necessary 
to so adjust the desk that its front edge may be on 
a vertical line one or two inches back of the front 
edge of the chair seat. The height of the desk 
should be so adjusted that its front edge will be 
on a line with the lower end of the sternum or 
breastbone of the pupil. This height of desk, with 
a properly adjusted chair, will require the pupil 
to maintain an upright position, and bring books 
within desirable distance to prevent eye strain. 
The seat should be in the form of a chair with 



Practical Hygiene 191 

slightly concaved bottom, of usual form. The 
seat must be adjustable as to height, and so ad- 
justed that when the pupil sits in an upright posi- 
tion the foot will rest securely on the floor with 
the thigh at right angles with the leg, and no 
pressure from the front and upper edge of the 
seat on the under surface of the thigh. The back 
of the chair should be somewhat concaved and 
the top rail should come well up on the shoulder 
blades, and be slightly inclined backwards. 

Another excellent and desirable feature in 
school chairs, but not often seen, is an adjustable 
hip or back rest so arranged that it may be raised 
or lowered in the middle half of the back, and also 
be slightly adjusted forward or backward. 

Adjustable chairs or desks are of no avail un- 
less teachers or janitors are held responsible for 
their adjustment. Teachers should understand 
the adjustment, and janitors should be required 
to do the work on request of the teacher. The 
matter must not be neglected. 

The matter of heating and ventilating large 
buildings has but recently emerged from a state 
of puerile uncertainty and attained the distinction 
of a full grown science. Each school building 
constitutes a problem for the expert sanitary en- 
gineer, who must not only formulate plans and 
specifications, but carefully supervise the installa- 
tion of the system, and test its working. 



192 Practical Hygiene 

While hot air furnaces are fairly satisfactory 
for the heating and ventilating of large build- 
ings, the air from furnaces is usually over-heated, 
and is usually so deficient in moisture as to be 
decidedly injurious. Either steam or hot water, 
therefore, should be used, the difference between 
the two being only a matter of economy. Heat- 
ing by either of these methods should, for econ- 
omy's sake, be both direct and indirect; direct, 
for the principal heat, and indirect for the pur- 
pose of warming the fresh air that is brought in 
through the ventilating flues. 

Ventilation must be by one of two systems, one 
known as the gravity system, by which air is 
introduced through a flue in which it is warmed 
by passing over a steam or hot water coil, and 
where the vitiated air is removed by rising 
through another flue to the roof of the building; 
the warm air of a room being lighter than outside 
air, it thus rises through the flue of exit and a 
circulation is established. This method will work 
satisfactorily if flues of exit are well heated, and 
other conditions are favorable, but otherwise the 
system is unreliable and will fail altogether at 
certain times. 

There is only one reliable system of ventilation, 
that is a mechanical system, operated either by 
an exhaust or pressure fan, which either draws or 
drives air through the room or building. 



Practical Hygiene 193 

Whatever system is used, it is inadequate if it 
fails to supply each pupil thirty cubic feet of air 
per minute. 

The inlet for air in the room of standard size 
should be four and one-half to five square feet, 
and the outlet not less than four square feet, for 
with flues of less size, sufficient air can not be cir- 
culated without causing too much draught. The 
efficienc}^ of the scheme for ventilating can be 
tested by measuring the number of cubic feet 
of air entering and leaving the room, by the use 
of the anemometer, one of which should be in the 
possession of each school principal. The best 
system of heating and ventilating is the one that 
is economical and at the same time insures the 
entrance of a proper amount of fresh air each 
minute, and provides also for the constant re- 
moval of vitiated air. 

The ventilating system for schools that depends 
on the heating system alone is worthless, as 
buildings must be ventilated in warm as well as in 
cold weather. Mechanical systems are worthless 
if not kept in constant operation. The care and 
maintenance of the heating and ventilating sys- 
tem should be in the hands of a janitor or engi- 
neer who understands thoroughly their mech- 
anism, the principles involved, and the necessity 
of ventilation. 

The temperature of the school room should be 



194 Practical Hygiene 

from 68 to 70 degrees, Fahrenheit. If, for any 
reason, the temperature of the room falls below 
60 degrees, Fahrenheit, the pupils should be 
promptly dismissed. 

Next in importance to heating and ventilating 
is the matter of humidity. Excessive dryness of 
indoor air is doubtless the cause of catarrhal and 
other troubles, and care must be exercised to 
maintain a humidity of 45 to 50 per cent, at a 
temperature of 68 to 70 degrees, Fahrenheit. Ex- 
cessive dry air seems colder at the same tempera- 
ture than moist air, therefore a proper degree of 
moisture results in economy of heat. Moisture 
can be supplied by a water pan in flues bringing 
in fresh air, or by evaporating it in the room. 
The degree of humidity may and should be meas- 
ured and regulated by the frequent use of the 
psychrometer. 

Modem flush closets and automatically flushed 
urinals should be located in well lighted rooms 
in the basement of the building, when good sew- 
ers and a plentiful supply of water are available. 
Floors and partitions of closets and urinals 
should be of asphalt and slate, and closets should, 
of course, be connected with the ventilating sys- 
tem. Washbowls should be located nearby and 
pupils directed to use them. Pupils should be re- 
quested to carry in their pockets small towels or 
napkins for their own use. In many cities and 



Practical Hygiene 195 

towns there are numerous large school buildings 
equipped with so-called dry closets situated in 
the basements, where excreta are deposited in 
vaults, and where it is intended that it shall be 
evaporated or dried by passing a current of warm 
air through the vault, whence it is conveyed by 
flues through the roof of the building. 

The dried excreta are finally disposed of by 
burning them in the vault with the aid of kerosene 
oil thrown over them. 

This system was originally planned so as to dry 
the excreta by taking warm air from the school 
rooms and by a system of flues carrying it over 
the excreta in the vaults and thence through the 
roof of the building. Such arrangements must 
not be tolerated, and where in use should be re- 
moved. 

A later device provides for the same treatment 
of excreta in vaults, but it is done by special fires 
and flues having no connection with school rooms. 
This system if applied in a building by itself, and 
disconnected from the school building, is doubt- 
less the best arrangement for disposing of ex- 
creta from school buildings where the service of 
sewers cannot be had, but no system of dry 
closets should be installed within the school build- 
ings, as they possess features which may get out 
of order or can be neglected, and when not work- 
ing well will create an intolerable and dangerous 



196 Practical Hygiene 

nuisance, by polluting the earth underneath the 
building and its foundation walls, and thus filling 
the building with a foul atmosphere. The dried 
excreta in these vaults should never be burned in 
the building, as their burning causes an intolerable 
stench in the neighborhood, and constitutes a 
great nuisance. 

Shower baths are inexpensive and much needed 
in some schools, and should more often be pro- 
vided. The water for the shower bath should be 
kept at a temperature of eighty degrees. Soap 
and towels should, of course, be furnished with the 
bath, but the janitor or attendant must see that 
towels should be used but once before being 
laundered. 

Drinking cups have doubtless been a means of 
communicating disease. 

To obviate this, drinking fountains have been 
much recommended and used of late. These are 
usually constructed in the form of a cup with a 
stream entering it at the bottom, filling it, and con- 
stantly overflowing its entire circumference, and 
thus supposedly carrying away at once any con- 
tamination that might be left by anyone in the act 
of drinking. 

These cups are sanitary and safe, and all 
schools should be provided with them. They are, 
however, decidedly objectionable from an aesthetic 
standpoint, and for pupils who will carry with 



Practical Hygiene 197 

them their own individual drinking cup, faucet 
water should be furnished. 

Dust in schools is a factor in air pollution which 
should be considered carefully. Much dirt is 
brought in on the shoes of children, and consid- 
erable is produced by wearing of floors, etc. 

I have given this subject much attention, and 
am thoroughly convinced that if floors are prop- 
erly oiled once in every four to six weeks and are 
gone over every night with a good floor brush, 
there will be less trouble from dust than by any 
other method of treatment. If any one will take 
the trouble to visit a large school at the time of 
dismissal in the afternoon, they will see in all 
rooms and halls of the building where floors are 
not oiled, great clouds of dust, which, in a half 
hour after the exit of the pupils will settle and 
be plainly seen in large amount on any smooth 
surface ; whereas, in the building where floors are 
oiled, but very little or no dust can be observed, 
except on the floor, where it is securely held by 
the oil, and from where it can be taken up with 
a brush without raising any perceptible dust in 
the room. 

Some prefer that floors should be mopped, but 
mopping of floors, as it is usually done in school 
buildings, does little else than wet down the dirt 
and dust, which when dried, will be seen to ap- 
pear on the floor as streaks or ridges of mud which 



198 Practical Hygiene 

will be broken up by the tread of pupils, and in 
the form of dust will be promptly distributed 
throughout the atmosphere of the building. 

Occasional physical exercise is essential for the 
relief of fatigue, caused, in young children, by 
sitting, and also for the promotion of mental 
activity. 

Proper gymnastic exercises promote deep 
breathing, develop the chest, strengthen the mus- 
cles, prevent round shoulders and spinal defects, 
and add to beauty of form and gracefulness of 
movement. If all schools could have the services 
of special teachers in physical culture, much good 
would be the result. 

Military drill is an excellent thing for boys of 
from twelve to fourteen years of age, and, where 
possible, it should be introduced into schools. 

The medical school inspector has a large field 
to cover, aside from looking into the matter of in- 
fectious diseases. He must be able to recognize 
defects of vision and hearing. Besides the risk 
of permanent injury, neglect or failure to recog- 
nize such defects, early in school life, compels 
the child to work under difficulties and seriously 
retards his progress. 

Adenoids and enlarged tonsils are very common 
troubles in school children, resulting in catarrhal 
conditions and mental dullness or defective mem- 
ory. All such conditions should be readily recog- 



Practical Hygiene 199 

nized, and, when found, parents should be in- 
formed of needed treatment. 

The medical inspector must thoroughly imder- 
stand the theory of heating and ventilating, and 
know well the operation of the system in operation 
in his school, and be able to say whether it is work- 
ing well or not. He must frequently inspect the 
closets and urinals, and see that a general condi- 
tion of cleanliness is maintained throughout the 
building. 

The teacher has also a duty in maintaining the 
hygiene of the school. Properly adjusted seats 
and desks will not insure proper postures of 
pupils, unless aided by the constant watchfulness 
and frequent admonitions of the teacher. 

Teachers must constantly inculcate the princi- 
ples of personal and general cleanliness, and of 
honesty and morality. They should also recog- 
nize the variations and limitations in the mental 
capabilities, and evil propensities of their pupils, 
and restrain the prodigies, assist the weak, and 
give personal advice to those who are toward evil 
inclined. 

I cannot refrain from speaking of a feature 
existing in many cities in connection with the pub- 
lice schools, which, according to the observation 
of many people conversant with the subject, is 
exceedingly detrimental to the efficiency of many 
schools. I refer to the so-called training class for 



200 Practical Hygiene 

teachers, where graduates from the local high 
schools are taken, and after a year and a half of 
service as assistants to teachers in the grammar 
schools, are sent forth as teachers, and immediate- 
ly political influence is sought and kept vigorously 
applied, until they secure a position. Few teach- 
ers are fitted for their work who have been de- 
prived of the influences of a proper home life. 

Moral and social elements of character should 
receive due consideration in the qualifications of 
teachers. 

The training of teachers should be left entirely 
to the Normal Schools and Colleges, and the selec- 
tion of teachers should be governed by the merit 
system, so applied as to positively exclude selfish, 
personal or political influences. 



MUNICIPAL HYGIENE. 

MUNICIPAL Hygiene refers to that sani- 
tary work which comes properly under 
the charge of a City Health Department. 
The work involved embraces the prevention and 
restriction of infections diseases, dairy, milk and 
other food inspections, a supervision over the 
water supply, the disposal of garbage and other 
waste materials, the construction of sewers; and 
inspection of tenements and lodging houses, of 
public, industrial and mercantile buildings, of 
school buildings and school children; of abat- 
toirs and noxious trades or industries, of markets 
and all places where food or drinks are manufac- 
tured or sold, and the inspection and abatement 
of all nuisances detrimental to health or influenc- 
ing unfavorably the peace, comfort or enjoyment 
of life or property rights. While the work re- 
quired is already large it is constantly increasing 
and demands the co-operation of specialists in 
sanitary engineering, in medicine, and the allied 
sciences of Biology, Bacteriology and Chemistry. 
The varied and important work required of sani- 
tary inspectors makes it essential that they 



202 P r actical Hygiene 

should have special instruction or practical exper- 
ience fitting them for their duties. 

INFECTIOUS DISEASES. 

Prevention or restriction of infectious diseases 
by sanitary officials rests on three important fac- 
tors, notification, isolation and disinfection. 

Without knowledge of the existence of infec- 
tious disease no restrictive official action can be 
expected. A failure to report, or a delay in re- 
porting communicable diseases by physicians and 
others having knowledge of their existence, may 
result in a serious epidemic, causing unnecessary 
loss of life, distress and expense to families, and 
inconvenience and loss to industrial and commer- 
cial interests of a municipality. 

In all epidemics it is the unknown or unrecog- 
nized cases that play the strongest part in the 
spread of infection. People who willfully conceal 
or fail to report to sanitary officials their knowl- 
edge of the existence of infectious diseases are re- 
gardless of the welfare of others and are danger- 
ous members of society. 

Doubtless some misguided people are led to con- 
ceal the presence of infectious disease in their 
families, from fear or dread of the restrictions of 
quarantine, and for this, health officials may 
some times be, in a measure, to blame, by reason 



Practical Hygiene 203 

of a maintenance of a too severe cr unnecessarily 
burdensome regime of quarantine. 

In the suppression of small pox, quarantine re- 
strictions can not be made too rigorous. It has 
been abundantly demonstrated that with the aid 
of vaccination, segregation, and disinfection this 
disease can be absolutely controlled. The nature 
of this disease and its manifestations render it 
practically certain, that all cases will come under 
medical attention and official supervision, thus 
giving every opportunity for effectual control. 

Diphtheria, scarlet fever, and the other infec- 
tious diseases should be totally suppressed as 
well as small pox, but it has been clearly demon- 
strated that their extinction in large cities is 
quite impossible in the light of present knowledge 
concerning them. First, we have for these dis- 
eases no preventive inoculations, except for diph- 
theria, and for that the immunity given is of very 
short duration. Second, this class of diseases 
often occur and run their course in such a mild 
form as to be unrecognized, and, consequently, 
they come neither under medical attention or offi- 
cial supervision. Thus it is plain that these mild 
and unrecognized cases are the strongest factors in 
the production of serious epidemics of scarlet 
fever and diphtheria. A most important feature in 
preventing the spread of infectious diseases is the 
maintenance by the city of a well equipped hos- 



204 Practical Hygiene 

pital, or rather hospital pavilions for the care and 
segregation of communicable diseases, including 
suitable places for suspects and convalescents. 
Another important duty of the department of 
health is to keep constantly on hand and furnish 
free to all who are unable to pay for them when 
needed, all preventive and curative serums. 

THE LABOEATORY, 

With the discovery of the tubercle bacillus by 
Koch in 1882, the importance of the laboratory in 
sanitary and public health work began to be mani- 
fest, and since that time scientific research and 
investigations in biology and bacteriology have 
established so many facts regarding the aetiology 
and pathology of disease, that empiricism has 
been practically relegated to ancient history. 

The laboratory in the last three decades has 
invaded the arts and sciences in every conceivable 
field, and rendered possible advances and results 
in medicine and sanitary science far in excess of 
centuries gone by. 

The laboratory is absolutely essential to pre- 
cision in the diagnosis of disease, and requires 
the co-operation of specialists in the allied fields 
of chemistry, biology and bacteriology. It should 
be an imperative duty, devolving on the governing 
bodies of municipalities, towns and rural districts, 
to furnish full and free laboratory facilities for 
the diagnosis of disease, and the general protec- 



Practical Hygiene 205 

tion of the public health by the chemical analysis 
and bacteriological examination of water, milk 
and other food products. 

THE WATEK SUPPLY. 

There is nothing of greater importance to a 
municipality than pure water and pure ice. 

The maintenance of a pure municipal water 
supply requires constant watchfulness. A chemi- 
cal and bacteriological examination of the water 
taken from the storage reservoir, various city 
taps, and also various points in the lake, stream, 
or streams forming the source of supply should be 
made weekly, and open records kept of date and 
results of such examination. Frequent chemical 
and bacteriological examinations render possible 
the early detection of sources of contamination. 
An examination of the water from streams con- 
tributory to the immediate source of supply is 
also of the utmost importance, and such examina- 
tion should be made frequently. 

A constant watching or patrol of all streams or 
lakes forming the city's water supply and of all 
streams or water sheds contributing thereto is 
essential in preventing all possible contamination. 

The contamination most to be dreaded and most 
dangerous to water supplies is that from the 
fecal discharges of human beings and the lower 
animals. Consequently there should be absolutely 



206 Practical Hygiene 

no drainage from privy vaults, cesspools or sta- 
bles, or from the surface of land npon which stable 
manure is used for fertilizing. Potable waters 
must, in fact, be kept free from all possible con- 
tamination of any kind. Bathing, and even boat- 
ing should be prohibited. 

It is of much importance for a municipality to 
own the immediate water-shed of its source of 
supply, as only by so doing can it absolutely pre- 
vent every form of pollution. Hotels or other 
habitations located near lakes or streams consti- 
tuting the city supply, require almost constant in- 
spection and supervision, and under the most fav- 
orable conditions will surely result in more or less 
contamination. 

PUEE lOE. 

Next in importance to pure water is an abun- 
dant supply of pure ice. Owing to natural and al- 
most unavoidable conditions there are, in close 
proximity to many cities, many streams and bod- 
ies of water that are so badly polluted that ice 
taken from them is obviously unfit for household 
purposes, and it is just as much a duty of the 
municipal authorities to prevent the harvesting, 
sale or use of ice from such sources as it is to pre- 
vent the use of such water for potable purposes. 
"When it has been demonstrated that water from 
a certain source is unfit to drink, it is then certain 
that ice taken from the same source is unfit for 



Practical Hygiene 207 

domestic use or to be used so that it may in any 
way come in contact with any food or drink. 

While contaminated ice may doubtless be safely 
used for cooling purposes, if it is permitted to be 
harvested and to enter a city for such purposes, 
it is very likely to be sold by unscrupulous dealers 
for other purposes ; or it will be secured in some 
way by those, ignorant or regardless of its source, 
and may thus be the origin of illness and death. 
Thus it is only safe for a City to prevent abso- 
lutely the entrance into its domains of any ice that 
is not from absolutely pure bodies of water, 
or to restrict the use or sale of ice within its lim- 
its, to that which is manufactured from pure 
water. 

DAIRY AND MILK INSPECTION. 

Dairy and milk inspection is an important duty 
of the health department. 

Safeguarding the milk supply must begin with 
a competent veterinary inspection of all cattle pro- 
ducing milk for the municipality, and a removal 
from the dairy herd of all cattle having diseased 
udders or any form of constitutional disease. The 
tuberculin test should be applied at least once each 
year, and no milk should be received from a farm 
where tuberculous cattle are known to be kept. A 
rule should insist that no additions should be made 
to the herd until the new animals have sucessfully 
passed the tuberculin test. The dairy inspec- 



208 Practical Hygiene 

tion should include an examination into the 
ventilation and other sanitary condition of the 
stables and milk room, yards and pastures, the 
water supply for cattle and washing utensils, the 
kind and quality of food, the hours for stabling 
and exercise, and the care given cattle as to 
grooming, bedding, etc. 

Knowledge must be gained as to health of sta- 
ble attendants, those who handle milk, and their 
families, and on all conditions and arrangements 
for handling, keeping and delivering of milk to 
customers, as well as names and addresses of cus- 
tomers supplied. 

The inspection or examination of milk for adul- 
teration requires the frequent use of the Lacto- 
meter and a complete analysis for the determina- 
tion of total solids, fat and water. 

An examination for impurities or bacteria re- 
quires that frequent bacteriological tests shall be 
made of milk as it is delivered to customers, as 
found at the farm ready for delivery and as found 
at various milk stations, stores, restaurants or 
hotels, as only by the examination of milk taken 
from the various places can it be determined 
where contamination takes place. 

An open individual card record should be kept 
in the office of the health department giving every 
possible detail of conditions revealed by the exam- 
inations in every department of inspection, and 



Practical Hygiene 209 

consumers of milk should be asked to come and 
investigate for themselves as to the character of 
milk they are getting. 

DISPOSAL OF CITY WASTE. 

An economical disposition of a city^s waste 
products requires that its various forms should 
be kept and handled in separate receptacles, and 
a city ordinance should so require of householders 
and others. A proper disposition of its various 
elements requires very different methods of hand- 
ling and treatment. 

GAEBAGE. 

Garbage is composed of all kinds of kitchen 
waste or swill, also of various forms of organic 
matter from shops, stores or markets. Its proper 
disposal is a matter of great sanitary importance, 
as such matter very rapidly decomposes and gives 
off noxious odors, pollutes air and soil, and thus 
becomes dangerous to health. In the country, 
kitchen waste can be properly disposed of by feed- 
ing to swine while it is still fresh. City garbage 
might be disposed of in the same way if it were 
possible to collect and deliver it to a proper 
place for keeping and feeding swine while it is 
fresh. But this is quite impossible, except in 
small towns where daily collections can be made 
and the distance for hauling is short. 

Garbage that it not strictly fresh and free from 



210 Practical Hygiene 

putrefaction is unfit for feeding swine, fowls or 
any animal designed for human food. 

There are only two strictly sanitary methods by 
which a city can dispose of its garbage. They are 
incineration and reduction. Many different forms 
of incineration or cremation plants have been con- 
structed, all of which by the process of evapora- 
tion and combustion will dispose of all forms of 
organic matter in a perfectly sanitary manner. 
The difference in utility and economy of the in- 
cineration plants varies only in the amount of 
fuel they require and their lasting qualities. The 
objection to the disposal of garbage by incinera- 
tion is only from the expense incurred. Owing 
to the large amount of moisture contained, the 
burning of garbage requires much fuel and the in- 
tense heat necessary combined with gases evolved, 
has such a destructive action on the structure of 
the plant that frequent repairs are necessary. 
Garbage contains a large amount of grease, which 
can be extracted, and is valuable for making soap. 
Garbage also contains bone, meat and other or- 
ganic elements valuable for fertilizing purposes. 

By the process of reduction all valuable ele- 
ments can be saved and should nearly, if not quite, 
pay the cost of treatment. Thus the disposal of 
garbage by reduction is economical and if the dis- 
posal plant be constructed according to modern 
and scientific principles, it will also be strictly 



Practical Hygiene 211 

sanitary as it can be operated without more odor 
or nuisance than comes from the carting of the 
garbage. 

There are reduction plants in operation where 
the garbage is cooked without condensing the 
vapors or steam and where the cooked garbage 
is dumped into open presses for the extraction of 
grease, altogether creating a nuisance of large 
proportions. 

I am strongly in favor of the process of reduc- 
tion, and believe the reduction plant should be 
owned and operated by the city, that the collec- 
tion of garbage, ashes and other refuse should 
also be made by the city, that daily collections of 
garbage should be made and that ashes and other 
rubbish should be collected weekly. 

By requiring a proper separation of all inflam- 
mable material, this matter can be utilized for 
fuel in the reduction plant. The ashes have a 
value equal to the cost of hauling, and besides 
there is much paper, rags, rubber, leather and 
metal that is well worth saving and has a ready 
sale. The garbage and other refuse that must be 
collected and disposed of by a city has a value that 
if properly handled should nearly, if not quite, 
equal the cost of collection and disposal. 

SEWERS. 

Notwithstanding the importance of drainage 



212 Practical Hygiene 

and sewage disposal, many cities or portions of 
cities are sadly in need of sewers, and for the lack 
of them there exist in certain localities numerous 
privy vaults or what are nearly as bad, cesspools. 
Privy vaults are an intolerable nuisance, pol- 
luting air and soil, and are a positive menace to 
health. The right to order the construction or re- 
construction of a sewer, or drainage of low land 
within the city, should rest with the Health Officer 
instead of the Councilmen, to whom political inter- 
ests or the whims of their constituents are of more 
importance than the welfare of the public health. 
Plans for the construction of sewers should be 
approved by the Health Officers before contracts 
are let. 

TENEMENTS AND PUBLIC BUILDINGS. 

Municipal sanitary laws should insist that plans 
for the construction of all buildings, especially all 
tenements, industrial, mercantile, office or public 
buildings provide for proper ventilation and give 
all possible protection to life and health. Laws 
should also provide that such plans be submitted 
to a competent sanitary engineer for his approval 
and also provide for his inspection during process 
of construction. Provision should also be made 
for routine inspection of all tenements, mercantile, 
industrial and public buildings to insure that 
proper sanitary conditions are maintained. Lodg- 
ing house keepers should be required to register 



Practical Hygiene 213 

with the department of health stating their loca- 
tion, number of rooms and beds, single or double, 
and also giving air space allowed for each lodger. 
Law should compel keepers to provide for free 
bathing and prohibit less than 400 cubic feet of 
space for each lodger. Also prohibit the use of 
comfortables which can not be satisfactorily 
washed, and make mandatory general cleanliness. 
Frequent inspection is however necessary to 
keep many of these places in even a fair degree of 
cleanliness, and to prevent crowding. 

MEAT INSPECTION. 

It is obvious that the meat of animals affected 
with any local or constitutional disease is unfit for 
human food. While thorough cooking and the 
natural protective action of normal digestion 
would doubtless prevent trouble in many and per- 
haps in most cases, meat is not always sufficiently 
cooked to destroy pathogenic bacteria, and that 
which might be consumed with impunity by a per- 
son in good health and with normal digestion 
would cause disease or death in another. Bad 
meat is certain to find its way into the markets of 
every city either through ignorance of butchers 
and dealers or through their willful and malicious 
intent. It is therefore necessary that the public 
be protected by a competent and systematic in- 
spection of all cold storage warehouses, markets 



214 Practical Hygiene 

and shops where meats are stored, packed or sold. 
After a diseased animal has been slaughtered and 
dressed, it is sometimes impossible by an ordinary 
inspection of the meat to say that the animal 
from which it was taken was diseased. Thus the 
fullest protection is possible only by an inspection 
before and during the time of slaughter. 

Most of the meat coming from western markets 
is inspected by government officials at time of 
slaughter and is safe meat if not kept too long in 
cold storage; but about many cities there are 
many small abattoirs which have no inspection 
and many individual farmers do their own killing 
and marketing, so that it seems necessary that 
state statutes should be enacted that will make it 
mandatory that all market meat shall be in- 
spected at time of slaughter and that all slaughter- 
ing for market must be done only at licensed abat- 
toirs for which inspection is provided. Oyster 
and fish markets need careful watching for the 
maintenance of cleanliness. Shell oysters and 
clams should be carefully washed before being 
opened, and the hands of the opener should be 
clean. 

POULTEY. 

State Law should prohibit the keeping, storage, 
or sale of poultry that has not been drawn at time 
of slaughter. Poultry, fish, game or any other 



Practical Hygiene 215 

animal to be used for human food should be drawn 
as soon as slaughtered, because the intestines at 
all times contain materials which have undergone 
putrefactive changes and the noxious gases and 
toxines therein contained should not be left to per- 
meate and contaminate the flesh, and render it 
nauseating and dangerous to those eating it. 
Under identical atmospheric conditions, drawn 
fowls will keep longer than those in which the 
viscera are allowed to remain. The presence of 
the entrails and their contents prevents rapid 
cooling after slaughter which is very essential to 
the keeping of meat, and thus favors early decom- 
position. 

The keeping of undrawn poultry should not be 
permitted even in cold storage. Cold or freezing 
will check or prolong the process of putrefaction 
but will not stop or prevent it altogether. After 
poultry or meat has been removed from cold stor- 
age or has thawed out after freezing, decomposi- 
tion goes on rapidly. 

"When the sale of undrawn poultry is permitted, 
unscrupulous parties will, just before slaughter- 
ing, feed fowls all they can eat of wet food (some- 
times mixed with sand) which will sell in the 
slaughtered fowl for many times its cost, and at 
the same time promptly sour, decompose and taint 
or spoil the flavor of the flesh, if not render it dan- 
gerous to life. It is repugnant to the sense of 



216 Practical Hygiene 

decency that flesh we are about to eat has lain for 
days or, in cold storage, for weeks and months in 
close proximity to poisonous intestinal contents. 
Unquestionably undrawn poultry or game has 
caused many cases of illness or ptomaine poison- 
ing which have been attributed to other causes. 

ABATTOIRS AND NOXIOUS TEADES. 

There are in or about nearly every city, abat- 
toirs, rendering works and plants for the manu- 
facture of fertilizers, or for other noxious trades, 
from which emanate filthy wastes polluting soil 
or streams, or foul and noisome gases or odors 
polluting air, any one of which elements is inju- 
rious to contigous property rights, prejudicial to 
the peace and comfort of neighboring people and 
dangerous to their health. No noxious trade or 
business should be allowed to exist and no plant 
constructed for such trade or business without 
permission from the department of health having 
jurisdiction, or without installing the most ap- 
proved arrangements for the complete protection 
of the health of employes and residents of the lo- 
cality and of surrounding property interests. 

The maintenance of such institutions in a prop- 
er sanitary condition usually requires frequent in- 
spection by sanitary officials. 

GENERAL FOOD INSPECTION. 

A full protection to the public health demands 



Practical Hygiene 217 

an official supervision of the manufacture and 
liandling of all food products and all drinks or 
beverages for the purpose of maintaining cleanli- 
ness and standards of quality and purity and, for 
this supervision, local health authorities should 
be held responsible. 

. This service requires systematic and competent 
inspection, with the co-operation and assistance of 
the chemist and bacteriologist. The inspection 
should go into every field of food manufacture 
and be followed on even to the consumer. 

COLD STOEAGE WAKEHOUSES. 

A place that has been much neglected is the cold 
storage warehouse. Unquestionably, food prod- 
ucts, especially meats, have been kept too long 
in. cold storage, and serious results have followed. 
State laws should regulate this industry by either 
limiting the time for keeping certain articles at 
definite temperatures, or requiring that every 
article or orginal package be labeled with date 
of entrance and exit from cold storage, and 
providing that retailers must offer for sale, or 
exhibit all meats and eggs in such way that the 
purchaser may know the length of time of storage. 

A strict regime of sanitary requirements should 
be fixed for cold storage warehouses, and an an- 
nual license fee required, the amount of fee to de- 
pend on the capacity of the house. 



218 Practical Hygiene 

INSPECTION OF GROCERIES AND SHOPS. 

An inspection of groceries, markets, bakeries 
and confectioners' shops is essential in certain 
quarters of all cities, in order to maintain a decent 
degree of cleanliness. The common practice of ex- 
hibiting or offering for sale, fruits, vegetables and 
even meats on the curb or walk in the open air in 
front of stores, a prey to the contamination of 
dogs, flies, dust and dirt of all kinds, is unsanitary 
and dangerous, and should not be tolerated. 

In many groceries, bake and candy shops, bread, 
cakes or confections will be exhibited on shelves 
or counters or in open trays, where in a short time 
they will be covered with dust from the street, 
brought in on shoes of patrons or blown in through 
the open window. While inspecting stores and 
markets, their refrigerators should not be neg- 
lected. They are places where cleanliness and 
ventilation are very important and often over- 
looked. Stale vegetables and decaying or fer- 
menting fruits are often the cause of serious 
digestive troubles and should be confiscated when- 
ever found. 

MEDICAL INSPECTION OF SCHOOLS. 

Infectious diseases are often communicated and 
spread over large areas, causing serious epidem- 
ics, by the close contact or association of children 
in the public schools. Through the indifference or 



Practical Hygiene 219 

ignorance of parents, sick or infected children fre- 
quently get into schools, this resulting in the 
spread of disease, loss of life or of much valuable 
time in school work, and pecuniary loss to fam- 
ilies ; and, in the case of epidemics, resulting in a 
disturbance and damage to the industrial and 
business interests of a city. The only method of 
safeguarding the public and school children 
against the spread of infectious diseases in the 
schools is to maintain a competent daily medical 
inspection of school children. If properly syste- 
matized, school inspection can be carried on with 
little interference with school work and the ex- 
pense incurred will be more than compensated for 
by the saving to the municipality of expense in 
the care of a much greater number of infections 
that would surely occur without the inspection. 
To prevent the spread of infection in schools, it 
is more essential that medical inspectors visit and 
examine promptly all absent children at their 
homes than to examine those in schools, as absen- 
tees are more likely to be out of school because of 
illness than from any other cause and they may 
return too soon. The school inspection that keeps 
sick children out of school is better than that which 
sends sick children away from school. Coincident 
with medical inspection, children should be taught 
the elements of hygiene and the way in which in- 
fectious diseases are communicated. 



220 Practical Hygiene 

Every kindergarten and primary school teacher 
should teach the following, taken from the nine- 
teenth annual report of the Superintendent of 
Health of the city of Providence. ^^ The poisons 
of some of the common and also of some of the 
most loathsome diseases are frequently contained 
in the mouth. In such cases anything which is 
moistened by the saliva of the infected person 
may, if it touches the lips of another, convey the 
disease. The more direct the contact the greater 
the danger. ' ' 

^' TEACH THE CHILDBBN 

Not to spit; it is rarely necessary. To spit on 
a slate, floor or sidewalk is an abomination. 

Not to put the fingers into the mouth. 

Not to pick the nose. 

Not to wet the finger with saliva in turning the 
leaves of books. 

Not to put pencils into the mouth or moisten 
them with the lips. 

Not to put money into the mouth. 

Not to put pins into the mouth. 

Not to put anything into the mouth except food 
and drink. 

Not to swap apple cores, candy, chewing 
gum, half eaten food, whistles or bean blowers or 
anything that is habitually put in the mouth. 

Teach the children to wash the hands and face 



Practical Hygiene 221 

often. See that they keep them clean. If a child 
is coming down with a communicable disease, it 
is reasonable to believe that there is less chance 
of infecting persons and things if the hands and 
face are washed clean, and not daubed with the 
secretions of the nose and mouth. 

Teach the children to turn the face aside when 
coughing and sneezing, if they are facing another 
person. 

Children should be taught that their bodies are 
their own private possessions, that personal clean- 
liness is a duty, that the mouth is for eating and 
speaking, and should not be used as a pocket, and 
the lips should not take the place of fingers. ' ' 

NUISANCES. 

From a sanitary or hygienic standpoint a nui- 
sance is anything detrimental to health or menac- 
ing the peace or comfort of body or mind. 

A large percentage of nuisances occur in or 
about tenement buildings occupied by poor peo- 
ple, where the cause is as much, and often, more, 
due to the owner than the occupant. It may be one 
or both, and is often hard to tell which is the more 
to blame. 

State or municipal laws regulating the construc- 
tion of tenements and stables, and requiring the 
maintenance of necessary sanitary requirements 
as to heating, ventilation and plumbing, will ob- 



222 Practical Hygiene 

viate much trouble from this source and prove a 
great boon to the poor. 

Time and space forbid the enumeration of the 
multitude of nuisances that may be brought to the 
attention of the municipal health department. 
The abatement of many nuisances requires the ex- 
ercise of mature judgment and discretion, and the 
patience of the perfect. 

A frequent barrier to official action in the abate- 
ment of nuisances is lack of mandatory authority 
and the necessity of enlisting the aid of the city 
department of law or the municipal court, where 
lack of hygienic training often dims the vision or 
appreciation of things sanitary, or renders them 
sensitive to the necessities of political favors and 
patronage. 

SMOKE. 

Common nuisances in all cities are those which 
cause atmospheric impurity. Among the most 
common of these are smoke and street dirt. 

Smoke is the result of imperfect combustion. 
With the imperfect combustion of coal there is 
thrown off noxious gases, soot, and tarry sub- 
stances, which, like all other dirt finds its way into 
every building and every conceivable place, pol- 
luting the air we breathe and injuring the health 
and doing much damage to households and general 
merchandise, besides being an annoyance and ob- 



Practical Hygiene 223 

noxious in other ways. In nearly every city there 
are multitudes of chimneys belching forth, un- 
necessarily, the products of imperfect combustion. 
Imperfect combustion is a waste of fuel. By per- 
fect combustion, soot, gas and tarry matter are 
burned, resulting in economy of fuel. Thus will 
abatement of the smoke nuisance cause no hard- 
ship. 

The smoke nuisance can be largely abated by 
intelligent stoking, and almost entirely so by at- 
taching to furnaces practical appliances designed 
for the purpose of consuming smoke. 

STBEET DUST. 

City dust is largely street dirt and is made up 
of all sorts of organic and inorganic matter, in- 
cluding horse dung and excreta of other animals, 
and contains living organisms capable of exciting 
various diseases as well as of being a damage to 
property and annoyance to homeholders. It is 
therefore essential to health that city streets be 
kept clean. The most sanitary method of clean- 
ing streets is by a thorough daily flushing and by 
promptly taking up and placing in receptacles the 
excreta of horses. 

SPITTING. 

Sanitary ordinances should prohibit spitting 
on sidewalks or on the floors of factories, public 
buildings, cars, or in public places. 



224 Practical Hygiene 

Expectorated matter from people having tuber- 
culosis or other diseases contains disease germs, 
which, when dried and in the form of dust, will 
find their way into the air passages of healthy peo- 
ple and excite disease. Tuberculosis, pneumonia, 
diphtheria and influenzas may be communicated 
in this way. Spitting is a nauseating and disgust- 
ing practice and should be stopped for aesthetic 
as well as sanitary reasons. 

SANITAKY EDUCATION. 

A city department of health can not fulfill its 
mission without carrying on a constant education- 
al campaign, especially among the poor and unin- 
formed. Cards of instruction, printed in various 
languages, should be generally distributed, giving 
needed information in the care and prevention of 
infectious diseases, tuberculosis in particular; 
and on the care of milk and its preparation for in- 
fant feeding, and the importance of general clean- 
liness and personal hygiene. Sanitary inspectors 
or competent visiting nurses should make frequent 
visits to infected households or the homes of bot- 
tle-fed infants and give such personal aid or in- 
struction as seems necessary to poor or ignorant 
people. All people should be urged to use milk 
bottled at the farm. Much good will follow the 
establishment of depots for the supply of modi- 
fied milk for infant feeding and, in summer, by 
furnishing ice to the sick and needy. 



' POLITICAL HYGIENE. 

EFFICIENT service on the part of a city de- 
partment of health requires that it be di- 
vorced from the vicissitudes of municipal 
politics and the dictum of public officials without 
sanitary training or knowledge, who have, fore- 
most in their minds, the distribution of political 
patronage or favors without regard to official fit- 
ness or results to the public health. 

Of first importance, then, are statutes permit- 
ting of proper organization. 

The statutes governing cities of the ^' second 
class '' in the State of New York, places the De- 
partment of Health under the charge of a '^ Com- 
missioner of Public Safety, ' ' who has jurisdiction 
over the departments of Health, Police and Fire. 
This official is invariably a layman, and quite as 
well fitted to dictate the policy of a department of 
health, as a blacksmith is to be judge of the Su- 
preme Court. 

By the provisions of the charter of second class 
cities, the Commissioner of Public Safety is di- 
rected to appoint a Health Officer. The Health 
Officer, may then, '^ with the consent and approval 



226 Practical Hygiene 

of the Commissioner of Public Safety, *' appoint 
an assistant Health Officer, and such minor offi- 
cials as '^are necessary,'^ or rather, as his superior 
may see fit to let him. While the charter says that 
the Health Officer may hold office during good be- 
havior, it also says that ^^ charges ^' may be pre- 
ferred to the Commissioner, from whose decision 
there is no appeal, thus making the tenure of of- 
fice for health officers most uncertain, as it is easy 
enough for any one to find complaints against 
every health official doing his duty without fear 
or favor. What nonsense! Such law is nothing 
less than a gross insult to the learned profession 
of medicine. But still worse, the charter specif- 
ically states that any act or decision of the Health 
Officer may be annulled or modified by the said 
Commissioner of Public Safety. Another insult 
to the medical profession ! What would the legal 
profession or the learned judges say of a law per- 
mitting a layman to annul or modify any act or 
decision of a supreme court judge ! 

The law in question furnishes the Health Of- 
ficer frequent opportunity for either the sacrifice 
of his self respect or the tender of his resignation. 

The originators and promoters of civil service 
evidently had in mind improvement and efficiency 
in public office, but its practical application in mu- 
nicipal appointments more frequently results in 
promoting the selfish aims and ambitions of the 



Practical Hygiene 227 

higher officials and political bosses. In fact, it 
seems according to common observation of its 
manipulation in municipal appointments to make 
easy and sure the appointment the administration 
or bosses desire to have made. At any rate the 
applicant desired, usually ^' passes the examina- 
tion. '^ Civil service should be absolutely under 
non-partisan control. The aims of public service 
and the interests of the public health should be 
higher than political ambition or the selfish inter- 
ests of petty politicians. The work in a city de- 
partment of health should be a service of experts. 
Efficiency of the department depends on the intel- 
ligence and experience of its inspectors. Ineffi- 
cient or corrupt inspectors render the department 
helpless. A faithful inspector or official who at- 
tends strictly to the duties of his office regardless 
of political pull, becomes more valuable with in- 
creased experience and should be protected in his 
position and receive a salary sufficient to encour- 
age him in continuing his work and merit ad- 
vancement. 

The police service of a city is in the interests 
of public safety and for this reason might well be 
under the control of the health department. 

Enforcement of excise laws governing the 
liquor traffic is of greatest importance to the pub- 
lic health and safety. This enforcement is de- 
pendent not alone on police patrol, but on the 



228 Practical Hygiene 

moral attitude of superior municipal officials, 
which the police are quick to recognize, and, ac- 
cording to it, govern themselves, with the result 
that many cities and towns are ^^ wide open '' at 
all times with full knowledge and approval of the 
administration and in flagrant and ridiculous de- 
fiance of state law, debauching public morals, 
working injury to the public health and depriving 
families of the comforts and necessities of life. 
The power behind the traffic in alcohol has too 
long influenced or dictated the policy of elective 
municipal officials, and the state should see that 
it can not leave to municipal officials the enforce- 
ment of state law relating to the sale of liquors 
without a deleterious influence on local affairs. 
If excise laws must be enforced by city officials, 
they should be state officers, or in some way taken 
from the influence of local politics. This should 
apply to both police and health officials. 

It is almost solely to the medical profession 
and the indefatigable and self sacrificing work of 
its members, that the public is indebted for the 
great advances in hygiene and sanitary science, 
and the consequent lessened mortality and im- 
proved social and physical conditions of life. To 
the medical profession as justly and solely belongs 
the matter of the protection of the public health, 
as does the matter of adjudicating the civil rights 
of the people to the legal profession. 



Practical Hygiene 229 

The game of politics in cities may be played in 
any other department, but not in the department 
of health. 

The Health Officer of a city should be elected by 
the people or appointed by the chief Health Officer 
of the state. His functions are as strictly judicial 
in character as are the duties of judges in the 
highest courts and his actions, if questioned, 
should be subjected to the review and action of 
the courts or the chief health official of the state ; 
not to the dictum of some petty boss or superior 
lay municipal officer who will object to any de- 
cision, order or action favoring even such impor- 
tant matters as pure water or ice, or to any ac- 
tion that he may think infringes on the personal 
rights or the business interests of his friends, or 
jeopardizes his personal or political interests, or 
the political interests of the city political organi- 
zation. There is nothing of greater importance 
than the interests of the public health. 

Sanitary law and authority should take prece- 
dence over all other interests. It should be first in 
peace, first in war and first in the minds of all good 
citizens. In the war with Spain the United States 
lost many times more men from preventable dis- 
eases than in battle, just because of defective ap- 
plication of ordinary sanitary requirements; not 
from lack of sanitary and hygienic knowledge, 
for its medical officers were the best equipped that 



230 Practical Hygiene 

ever faced an enemy, but because sanitary author- 
ity was not supreme but was made subservient to 
policy, caprice, or politics. 

Japan, in ber recent war with Eussia, has given 
the world its best lesson in the practical applica- 
tion of hygiene, and has clearly demonstrated that 
a regiment of healthy troops is worth a whole 
army of invalids. In the Japanese army, sanitary 
officials had supreme authority and sanitary law 
was first and foremost, and a gigantic war was 
conducted under adverse conditions with death 
and disability from general causes scarcely more 
than under ordinary conditions of life. What is 
good for an army, is good for a state, municipal- 
ity or an individual. A public service that is es- 
sential becomes a duty. A public duty is always 
plain and never conflicts with honest business 
methods or individual rights. What is good for 
the public, is good for the individual citizen. 
There has been a contention that health laws can 
not be enforced in advance of the intelligence of 
the people who, ignorant or wise, should have the 
right of suffrage, but what is right should always 
be might in matters pertaining to the public 
health. 

As before stated, the matter of protecting the 
public health belongs to the medical profession 
and, until the rights of the medical profession are 
given due and complete recognition, it should be 



Practical Hygiene 231 

the duty of physicians and sanitarians to make 
their influence felt in state and municipal politics. 
Physicians are men of broad, general intelligence 
and better fitted by their superior knowledge of 
humanity for ministering to the demands and 
needs of the public, than any other class of men. 



FAEM HYGIENE. 

IN rural districts, and especially on the farm, 
ordinary hygienic requirements have been 
much neglected. At any rate, country dis- 
tricts have not kept pace with the cities in sani- 
tary progress. 

This fact is evident when we consider that in 
most large cities death rates have materially 
diminished, while in the country they have dimin- 
ished to a less degree, in some places remain as 
heretofore, and in others have actually increased. 

The foregoing statements are applicable to 
mortality from typhoid fever more than to that 
resulting from any other disease. The existence 
of this disease is well known to depend largely 
on its distribution in water supplies. 

While it may seem paradoxical that the water 
supply of cities is generally safer than that to be 
found on the farm, it is, nevertheless, true, with 
occasional exceptions. 

The reasons for existing conditions are plain 
enough to anyone who will take the trouble to ob- 
serve the water supply and drainage systems 



Practical Hygiene 233 

maintained by many of the medimn or non-pro- 
gressive class of farmers. 

A large proportion of rural population depends 
on wells for its water supply ; and it is well-water 
that is most often contaminated by drainage from 
the privy vault, stable or cesspool, or kitchen 
slops thrown upon the ground, which, through 
porous soil or in seams in rocks, will often find its 
way to the well, far from the place of its original 
deposit. 

The proper disposal of human excreta is a mat- 
ter of first importance, even on the farm. If de- 
posited in vaults, they should be water-tight, and 
so constructed that their contents can be easily 
and frequently removed. 

So-called dry or earth closets, in the absence of 
better conveniences, will answer an excellent pur- 
pose if properly cared for. 

Excreta can be safely and economically dis- 
posed of by spreading them thinly on cultivated 
ground and covering or mixing them with soil, 
where they act as a fertilizer, and their danger- 
ous properties are rapidly destroyed. 

For the removal of kitchen slops, surface drains 
made of stone or brick answer a good purpose in 
summer, but are of little use in winter. Kitchen 
slops are better cared for by connecting a box 
with a strainer at its outlet to a hundred feet of 
porous tile laid two or three feet underground. 



234 Practical Hygiene 

After laying the tile, the trench should be par- 
tially filled with broken stone, and that covered 
with earth. The distal end of the tile should be 
brought above the surface of the ground to pro- 
vide for free circulation of air through the drain. 

Such drains should, of course, not start from 
within the house, unless brought in with iron or 
lead pipe and trapped. This drain will last for 
many years, and will answer for all waste water, 
but not for fecal matter. 

In houses having water service the question of 
sewage disposal must be considered. 

The problem has heretofore been met by drain- 
age into streams or by the cesspool. The first 
causes stream pollution; the second causes both 
the pollution of soil and water supply; and, be- 
sides, cesspools are troublesome things in various 
ways. 

The problem of the sanitary disposition of sew- 
age for country residences has been satisfactorily 
solved by the advent of the septic tank, which 
may be cheaply built of cement, and from which 
the effluent may be safely discharged into streams, 
or disposed of by subsoil drains. 

A pure water supply is essential not only for 
drinking and domestic purposes, but for use in 
the dairy and for stock. 

Washing or rinsing milk bottles, cans or other 
utensils, in water infected by the typhoid bacillus. 



Practical Hygiene 235 

is likely to infect the milk and spread the disease 
over an entire milk route. 

Care must be taken that milch cows be supplied 
with clean, wholesome water, and that they be not 
allowed to drink from pools or streams in which 
they can wade and drop their excreta, as by so do- 
ing they will pollute their bodies and udders with 
mud and other filth, some of which will surely find 
its way into the milk pail. 

The hygiene of the stable is a matter often much 
neglected. Stables should have high ceilings, 
abundant light and air space, and be well ven- 
tilated. Floors should be dry, and water-tight 
gutters, preferably of concrete, should collect and 
save all liquid discharges, which, for sake of econ- 
omy in the saving of their valuable fertilizing ele- 
ments, should be absorbed by the daily use of peat, 
cut straw or other litter. 

Water-tight floors and gutters prevent pollution 
of soil underneath the stable, and resulting foul 
odors and dampness. They can also be cleaned 
by occasional flushing. The use of gypsum or peat 
in stable gutters serves the triple purpose of ab- 
sorbing, of deodorizing, and adding to the fertiliz- 
ing value of stable manure. Stables should be 
cleaned daily and the manure carted directly to 
the field. 

Pig-pens should have water-tight floors, prop- 
erly graded, and should be cleaned daily. No 



236 Practical Hygiene 

drainage from them should be permitted under- 
neath or about the pen. 

A careful saving of all manure and its immedi- 
ate removal to land where it is needed is essential 
for sanitary and economic reasons. A filthy barn- 
yard is not only an eyesore, but directly pollutes 
the bodies of cattle and thus, indirectly, the milk 
pail. In order to keep the barnyard in good con- 
dition, it is quite essential that it be surfaced with 
gravel or macadam and be drained with porous 
tile laid about two feet below the surface. 

In the farmhouse and in its cellar, sunlight, 
cleanliness and ventilation are demanded. 

If cisterns must be used for the storing of rain- 
water, it is better to locate them outside the house, 
as when located in the cellar more or less damp- 
ness is caused in the house. Cisterns should be 
tightly covered and frequently cleaned. Cistern- 
water is not safe for potable purposes or for the 
washing of kitchen, table or dairy utensils, until 
it has been well filtered and boiled. 

The farm house and milk-room, more than any 
other house, needs to be screened to prevent con- 
tamination from flies coming from the hennery, 
pigpen or stable. 

The successful farmer must be an active stu- 
dent. He must know that for every crop the soil 
gives him, something must be returned, or his 
farm must finally be abandoned. He must study 



Practical Hygiene 237 

soil chemistry, the nutritive requirements of 
soils and their adaptability for various crops, the 
advantages of crop rotation, and the benefits to 
be derived from proper drainage. He must know 
when to cut noxious weeds to prevent their future 
growth. He must provide for the future by main- 
taining the fertility of the soil, and by the plant- 
ing of forest trees on land that is of little value 
for other purposes. 



INDUSTEIAL HYGIENE. 

HYGIENE and aesthetic environment have 
important relations to business and in- 
dustrial economy. 

The building of shops and factories in salubri- 
ous locations and their maintenance in a sanitary 
condition by providing sufficient light, air space, 
proper heating and ventilation, adequate closet, 
bathing and other facilities for the promotion of 
the health, comfort and enjoyment of employees, 
aid largely in insuring the satisfaction and co- 
operation of those employed, thus bringing better 
better returns in labor. 

If lawns, trees and flowers can be cultivated 
about industrial institutions, they also add much 
to the opportunities for pleasure and enjoyment 
of life by people who are always deprived of 
much of Nature's beauty. 

There are various industries or employments 
that unavoidably jeopardize the lives of em- 
ployees, or injure their health and reduce the ex- 
pectation of life. It is the duty of employers to 
furnish every safeguard against injury, for the 
prevention and removal of dust of all kinds, and 



Practical Hygiene 239 

the maintenance of a general environment favor- 
able to health. 

In large factories, antiseptics and necessary 
materials for the temporary dressing of womids 
should always be furnished and ready for use. 

A sufficient number of cuspidors should also 
be provided and must be cleaned daily. 

Much good will result from the posting of 
notices prohibiting spitting upon the floor, and 
instructions demanding the maintenance of per- 
sonal and general cleanliness. 



ECONOMIC HYGIENE. 

BY the better drainage of land, by preserving 
the purity and regulating the flow of 
streams, by the storage of storm water, by 
the development of water powers for the genera- 
tion of electrical energy, and by the planting and 
cultivation of forests, there are great opportuni- 
ties for improving general hygienic conditions 
and at the same time largely advancing industrial 
progress and adding to the beauties of nature. 

STREAM POLLUTION. 

Normal or pure water courses are of utmost 
economic value to all communities, cities or locali- 
ties for domestic and manufacturing purposes, 
for water power and as avenues of transporta- 
tion, for harvesting of vast stores of ice, and as 
a source of food supply through fisheries. The 
aesthetic value of pure streams or lakes for places 
of amusement or recreation is of much impor- 
tance. Many cities and communities have learned 
by bitter experience the dangers of polluted 
waters. Many streams and bodies of water have 
been depopulated of fish by the presence of sew- 



Practical Hygiene 241 

age or of industrial waste. In many densely pop- 
ulated areas, natural water resources have been 
destroyed or largely diminished by sewage pollu- 
tion, and the financial loss thus entailed has be- 
come a factor of great importance. Sewage pol- 
lution of streams in the eastern states has been 
very rapid in recent years, not only because of 
rapid increase in population but by reason of the 
rapid spread of sewer systems into small towns, 
with the result that in some streams pollution has 
become a positive nuisance, while in others it has 
produced no visible effect but has destroyed the 
water for potable purposes. Experience and the 
results of bacteriological examinations show the 
dangers of depending on the forces of nature for 
destroying the effects of stream pollution and, in 
fact, have proven that disease germs may be 
water-borne for long distances and for long peri- 
ods of time. The remedy for the prevention of 
stream pollution lies in the more general adoption 
of systems of sewage disposal. Inasmuch as a 
city or community may be injured by stream pol- 
lution having its origin in another state, the sub- 
ject deserves consideration and action by national 
as well as by state authorities. 

SANITAEY SEWAGE DISPOSAL. 

By the term, '^ sewage," is generally implied 
human excreta and liquid waste or drainage from 



242 Practical Hygiene 

households, stables or other buildings, and indus- 
trial liquid wastes. 

Its immediate disposition in cities having ade- 
quate sewers is of little concern to its producers, 
where their buildings are equipped with modern 
plumbing. 

The proper disposal of sewage is a matter of 
much sanitary importance to households deprived 
of the privilege of adequate sewers; for without 
these the pollution of wells or soil about the 
premises is certain to occur from vaults or cess- 
pools or the throwing about of slops or other 
noxious matter, resulting, either in the produc- 
tion of disease, or in conditions both obnoxious 
and injurious to health. 

It is to the city or town that the problem of 
sewage disposal becomes a matter of greatest con- 
cern and economical interest, when its own water 
supply is menaced by sewage pollution or when it 
is directed by the State, in the interests of vested 
property rights or for the welfare of the public 
health, that it must not pollute, or must cease to 
contaminate, certain waters, either by diverting 
its sewage therefrom, or by providing for the ex- 
traction or destruction of the dangerous organic 
elements of the sewage, and permit of the dis- 
charge into streams or other bodies of water of 
only its innocuous effluent. This treatment of 
sewage is termed sanitary sewage disposal. 



Practical Hygiene 243 

The common method of sewage disposal by 
cities has been by its discharge into the most con- 
venient stream or body of water. 

With the rapid increase of rural and city popu- 
lation and the more general use of streams and 
lake waters for the discharge of sewage, the pollu- 
tion of many public waters has become very 
great; and authorities have become alive to the 
fact that pure water, without a sanitary disposal 
of sewage, will soon be impossible, and not only 
that further pollution must cease, but that many 
streams and bodies of water must be relieved 
from the contamination that is now constantly 
taking place. 

It is said that even Lake Michigan is showing- 
such a degree of contamination from the vast 
amount of sewage discharged along the Illinois 
shore, that some remedy will soon be imperatively 
demanded. The result will be that all towns de- 
siring to establish a system of public sewers must, 
before they can construct such system, provide 
for some method of sanitary sewage disposal, 
and that many inland cities and towns will also, in 
the near future, be required to reconstruct their 
present sewer systems so as to provide for sew- 
age disposal. 

Seacoast towns are fortunate in their exemp- 
tion from such requirements. Sewage discharged 
into the sea is carried away by outgoing tides, 



244 Practical Hygiene 

and is so largely diluted that no nuisance results. 

When it becomes necessary for a city to provide 
for sanitary disposal, economy demands that the 
volume of sewage be restricted by diverting from 
sewers all surface or storm waters. This proce- 
dure requires the construction and maintenance 
of two distinct drainage systems, as oftentimes 
the storm water is far in excess of the volume of 
sewage, and, besides, needs no treatment. 

The necessity for sanitary disposal of sewage 
has been recognized in Europe for fifty or more 
years and various systems have long been in 
fairly successful operation. 

The first method of sewage disposal was its use 
for irrigation of land and its application as a fer- 
tilizer. This method of disposal is still in use in 
some European countries, where large sewage 
farms have been established and are still working 
satisfactorily, yielding good profits beyond the 
expense of maintenance. This method is, how- 
ever, in some localities, either inexpedient, ex- 
pensive or unsatisfactory and difficult of manage- 
ment, owing to the long distances that sewage 
must be conveyed and the difficulty in obtaining 
suitable and adequate land. In localities where 
irrigation is essential to the growth of vegetation, 
this method of sewage disposal can be used to 
excellent advantage. 

About 1870 the chemical precipitation process 



Practical Hygiene 245 

was introduced first in Europe and, about ten 
years later, in Worcester, Massachusetts, and a 
few other small towns. In this method, as the 
sewage flowed into tanks, chemicals were added, 
and by their action most of the suspended and 
about half of the soluble organic matter was pre- 
cipitated, which was afterward removed, pressed, 
and used for filling or fertilizing land, while the 
effluent was discharged into streams. This 
method has been found expensive of operation 
and has not come into general use, and in some 
places where still used, sand filter beds have been 
supplemented for the better and more complete 
purification of the effluent. 

Latterly, so-called intermittent filtration has 
been more in use. In this process several beds 
were constructed of intermittent layers of coke, 
gravel or broken stone, over which sewage was 
run alternately for short periods, and in which 
bacterial action, aided by filtration, destroyed or 
removed organic matter or converted it into 
harmless elements, leaving an effluent of compara- 
tive purity. 

A careful study of the bacteria in these filtra- 
tion beds has led to the discovery of natural bio- 
logical processes which now bid fair to satisfac- 
torily solve the problem of the sanitary disposal 
of sewage, which, wherever attempted by former 



246 Practical Hygiene 

methods, has been a source of great expense, 
much trouble and often doubtful efficacy. 

Observation and experimentation have clearly 
demonstrated that when sewage has been deposit- 
ed in a water-tight and closed receptacle like a 
well or cesspool and allowed to stand undis- 
turbed for a short time, that bacteriological action 
renders soluble nearly all suspended material, 
and changes poisonous organic matter into innoc- 
uous mineral elements, which, with the resulting 
effluent, can afterward be discharged into streams 
without serious contamination. 

Thus has been developed what is now well 
known as the '^ septic tank '^ method of sewage 
disposal. This method can be applied and main- 
tained with comparatively small expense and with 
equal success to a city, town or household system 
of sewers. 

In small towns, in rural districts, and on the 
farm, many households are deprived of conven- 
iences essential to their comfort, from the lack of 
proper drainage; or their lives are endangered 
by the contamination of wells or other sources of 
water supply from privy vaults, cesspools, stables 
or kitchen slops. In such places the septic tank 
will satisfactorily supply a long felt want. 

SOIL DRAINAGE. 

Excessive soil moisture doubtless favors the 
development of certain diseases. Experience 



Practical Hygiene 247 

proves that the general health of people dwelling 
over damp soils is inferior to those living in dry 
places. Wet soil is cold and causes dampness of 
the atmosphere and predisposes to rheumatism, 
malarial and respiratory diseases. It is certain 
that permeability of soil to moisture favors vari- 
ation in its temperature and its conditions for 
evaporation, thus favorably affecting atmospheric 
conditions and bearing an important relation to 
the well being of both animal and vegetable life. 
Thus hygienic conditions in many localities may 
be much improved, either by open ditching, by 
laying of porous tile drains, or, by driving wells 
through permeable strata into porous subsoil, as 
conditions may demand. Soil drainage greatly 
improves the fertility of certain lands and con- 
verts vast areas of worthless land into most pro- 
ductive farms. 

BEGULATION OF STREAMS. 

Much practical economic and hygienic work is 
yet to be accomplished by regulation of the flow 
of streams and prevention of floods, by the stor- 
age of storm water. The property damage yearly 
done by floods reaches enormous proportions, be- 
sides the inconvenience to industries and general 
business interests and the unsanitary conditions 
produced by flooding of lands, cellars or habita- 
tions. The removal of forests from vast areas of 



248 Practical Hygiene 

land has caused a greater variation in the flow of 
streams and more frequent and greater floods, 
until it seems that states or communities must co- 
operate for protection, by the building of dams or 
storage reservoirs, where storm water may be 
held and so discharged as to maintain an equable 
stream flow. Water stored for the prevention 
of floods can be utilized for the generation of 
power or electrical energy. The magic and 
beauty of electricity in its silent power and mag- 
nificent displays, its utility and endless industrial 
application, should not only aid and stimulate the 
conserving of the forces of stream water, but also 
the development of an immense amount of latent 
power from the natural flow of streams that has 
heretofore been neglected. There is much econ- 
omy in electricity generated by water power. It 
saves coal and the nuisance of smoke and adds 
to the pleasures and enjoyments of life. 

FOKESTKY. 

The preservation of large areas of forests in 
certain sections of the country are of much hy- 
gienic and economic importance. 

Forests are of hygienic value by their favor- 
able atmospheric influence in consuming air im- 
purities and adding to it its most essential ele- 
ment; for their influence on the distribution of 
surface water and the perpetuation and regula- 



Practical Hygiene 249 

tion of the flow of streams ; and of economic im- 
portance, in the supply of wood and lumber. The 
deforestation of large sections of country and the 
consequent rapid melting of snow, and the quicker 
filtration of water, with the resulting rapid mo- 
tion of surface water and streams, have washed 
from the uplands and hillsides much valuable 
humus, working great injury to the soil; and, as 
the floods gather in the valleys, they do greater 
damage to the flats by the washing out of gullies, 
the destruction of crops and the flooding of prop- 
erty. Destruction of forests causes more rapid 
evaporation of soil and surface water, and alto- 
gether the result has been to threaten or destroy 
many important water resources as well as other 
interests, the necessity of maintaining which is 
constantly becoming more and more important 
with our rapidly increasing population. 

Lumber in the United States has formed one 
of its prominent resources. It will always be a 
necessity. It is rapidly disappearing and the 
amount required is increasing rapidly each year. 
In twenty years at the present rate of use and nat- 
ural increase of consumption, there will be little 
if any left of forests now existing. It is not only 
essential for all interests involved that present 
forests be preserved, but that large areas of land 
in different sections of the country be reforested. 

The problem is an important one for the per- 



250 Practical Hygiene 

petuation of water resources and tlie protection 
of agriculture and, in view of the enormous 
amount of timber required, it is a pressing one 
and must soon be taken up on a gigantic scale by 
both national and state governments. There is 
hardly a section of country in which valuable 
timber of some kind cannot be grown and in every 
state there are sections of land better adapted 
and more profitable for the growth of timber than 
for other purposes. Such lands, if planted to 
timber adapted to the locality, can at the end of 
fifteen or twenty years be made to yield large 
profits. Laws should be enacted requiring all 
large landowners to plant to timber a certain 
acreage yearly. 

Ten years will grow a good fence post; in fif- 
teen years the same tree will make two ; in twenty 
years the tree will make a railroad tie and two 
posts. 

There is to-day no more important public and 
economic question for consideration than forestry. 
Forests are necessary to perpetuate our water 
supplies, for the protection of agriculture and the 
direct supply of a great necessity. 



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